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Digoxin withdrawal in patients with sinus rhythm
Insights
For elderly patients with sinus rhythm, stopping maintenance digoxin treatment was unnecessary in 90% of cases. This study assessed clinical and echocardiographic outcomes after digoxin withdrawal in outpatients.
Area of Science:
- Cardiology
- Geriatric Medicine
- Clinical Pharmacology
Background:
- Digoxin is a cardiac glycoside commonly prescribed for heart conditions.
- Its long-term necessity in elderly patients with sinus rhythm requires evaluation.
- Maintenance therapy aims to sustain clinical benefit and prevent relapse.
Purpose of the Study:
- To assess the need for maintenance digoxin treatment in elderly outpatients with sinus rhythm.
- To determine the clinical and physiological effects of discontinuing digoxin.
- To evaluate the safety and efficacy of stopping digoxin in this specific patient group.
Main Methods:
- A prospective trial involving 10 elderly outpatients with sinus rhythm.
- Digoxin was withdrawn, while other medications remained unchanged.
- Weekly clinical assessments, systolic time intervals, and M-mode echocardiography were performed over 5 weeks.
Main Results:
- Clinical condition deteriorated in 2 out of 10 patients after digoxin withdrawal.
- The remaining 8 patients tolerated the cessation of digoxin without adverse effects.
- Maintenance digoxin therapy was found to be unnecessary in 90% of the selected cohort.
Conclusions:
- Maintenance digoxin treatment is likely unnecessary for a significant majority of elderly outpatients with sinus rhythm.
- Careful patient selection and monitoring are crucial when considering digoxin withdrawal.
- Further research could explore predictors of digoxin response in this population.
Abstract:
The need for maintenance treatment with digoxin was assessed in 10 elderly outpatients with sinus rhythm. Digoxin was withdrawn on the first day of the trial but any other treatment remained unchanged. The participants were seen once weekly on the same day for 5 consecutive weeks and assessed clinically, by the calculation of systolic time intervals and by M-mode echocardiography. In 2 patients the clinical condition deteriorated but in the rest digoxin was stopped without detrimental effects. Therefore, in the patient population selected, maintenance treatment with digoxin was deemed unnecessary in 90% of cases.