Key result
The routine use of digoxin in elderly patients with left ventricular failure and sinus rhythm may not be clinically justifiable due to the risk of toxicity outweighing therapeutic benefits.
Why the study?
Does digoxin provide therapeutic benefits that outweigh toxicity risks in elderly patients with left ventricular failure and sinus rhythm?
Does digoxin provide therapeutic benefits that outweigh toxicity risks in elderly patients with left ventricular failure and sinus rhythm?
Routine long-term use of digoxin in elderly patients with heart failure and sinus rhythm may not be justified due to toxicity risks, warranting careful evaluation and potential withdrawal.
Answers are grounded in this paper and cite their sources.
May support avoiding routine digoxin in elderly LV failure with sinus rhythm; leaves open confirmation by RCTs.
The current extensive use of digoxin in elderly patients with left ventricular failure and sinus rhythm may not be clinically justifiable; in a significant proportion of these patients the frequency of digitalis toxicity may outweight the therapeutic benefits of the drug. When digoxin is used in elderly patients, the specific geriatric pharmacology of the drug must be considered. Clinical benefit should be documented before proceeding to long-term maintenance therapy. In selected elderly patients, withdrawal of digoxin with careful follow-up may be a worthwhile procedure. Studies are needed comparing the relative benefits and toxicities of digoxin versus diuretics in the management of heart failure in the elderly.
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Barry M. Stults (1982) conducted a review in Left ventricular failure and sinus rhythm. Digoxin was evaluated. The routine use of digoxin in elderly patients with left ventricular failure and sinus rhythm may not be clinically justifiable due to the risk of toxicity outweighing therapeutic benefits.
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