[Digoxin in chronic heart failure and sinus rhythm: is the end of the controversy in sight?]

It has for years been a matter of debate whether digoxin may/should be used in chronic heart failure with sinus rhythm. Interest in digoxin was renewed when it was found that the substance had a vagotonic as well as a sympatholytic effect in heart failure patients. A recent clinical trial led to the conclusion that although digoxin had no effect on the mortality among heart failure patients, it did lead to a reduction of the number of hospital admissions, particularly because of heart failure (indicating reduced morbidity and deceleration of the progression of the disease). Many heart failure patients continue to have symptoms in spite of treatment with diuretics and ACE inhibitors. As only few alternatives are available, many physicians in the near future will go on using digoxin in these patients- and as the recent study shows, rightly so.