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When, and when not, to use digoxin in the elderly
A T Gosselink1, D J van Veldhuisen, H J Crijns
1Department of Cardiology/Thoraxcenter, University Hospital Groningen, The Netherlands.
Drugs & Aging
|June 1, 1997
Summary
Digoxin can help manage heart failure symptoms and reduce hospitalizations. It may also control heart rate in chronic atrial fibrillation (AF), especially in elderly patients, but requires careful dosing to avoid toxicity.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Digitalis, including digoxin, has a long history in treating cardiac conditions.
- Recent findings guide its current application in heart failure and atrial fibrillation (AF).
Purpose of the Study:
- To review the contemporary role of digoxin in managing heart failure and AF.
- To assess digoxin's efficacy and safety based on recent evidence.
Main Methods:
- Review of recent study findings on digoxin's use in heart failure and AF.
- Analysis of digoxin's effectiveness in different patient populations and clinical scenarios.
Main Results:
- Digoxin is considered for heart failure with systolic dysfunction when ACE inhibitors and diuretics are insufficient, potentially reducing hospital admissions.
- Digoxin can be effective for ventricular rate control in chronic AF, particularly in sedentary or elderly individuals.
- Digoxin is not effective for rhythm control or paroxysmal AF management and carries toxicity risks in the elderly, necessitating cautious dosing and alternative strategies.
Conclusions:
- Digoxin remains a valuable option for specific heart failure and AF management scenarios.
- Careful dosage titration and consideration of alternatives are crucial, especially in elderly patients, to maximize benefits and minimize toxicity.