Key result
Digoxin remains useful for HF and AF but elevated levels are linked to increased mortality.
Why the study?
Digoxin is still used for heart failure and atrial fibrillation but frequently causes toxicity and elevated serum levels are linked to increased mortality.
While digoxin remains a useful therapy for refractory HFrEF and atrial fibrillation rate control, clinicians must remain vigilant for toxicity due to its narrow therapeutic window and numerous drug interactions.
Vigilance for digoxin toxicity remains essential in HF and AF; leaves open its optimal role amid modern therapies.
Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.
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Crane et al. (2024) conducted a review in Heart failure and atrial fibrillation. Digoxin was evaluated. Digoxin remains a useful treatment for heart failure and atrial fibrillation, but its narrow therapeutic index frequently causes toxicity, and elevated serum levels are associated with increased mortality.
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