Contemporary Use of Digoxin in the Management of Cardiovascular Disorders

Dirk J. van VeldhuisenCardiologist, University Medical Center Groningen

“Twenty-five years ago, digoxin was used by around two-thirds of patients with moderate to severe (systolic) HF, although there were large variations in its use in Europe, ranging from 85% in Germany to 40% in the United Kingdom. Since then, however, the use of digoxin has markedly declined and in more recent HF trials, its use was reported to be <20%, or-most recently-not even mentioned anymore.”

“Digoxin has unique, if still not completely understood, pharmacodynamic effects. It has positive inotropic effects on cardiac myocytes, presumably due to increased intracellular calcium. It was initially used in treating 'dropsy' (congestive heart failure), with subsequent documentation of its beneficial effect on ventricular function.”