Digitalis in congestive heart failure

The indications for digitalis glycosides in the treatment of congestive heart failure with sinusrhythm have been disputed since early in this century. In the last decade several well designed studies have been published that have established the effectiveness of digitalis in this condition. However, new groups of drugs have been introduced in the treatment of heart failure and have been compared with digitalis. Ibopamine appeared to be an effective alternative for digitalis in patients with heart failure of low NYHA class. Because of their proven favourable effect on patient survival, ACE inhibitors are replacing digitalis as first-line drug--after diuretics--in the treatment of congestive heart failure. In this review of the literature the present place of digitalis in the treatment of heart failure is discussed.