Why the study?
Does oral digoxin prevent clinical deterioration in geriatric in-patients with sinus rhythm or atrial fibrillation compared to placebo?
Does oral digoxin prevent clinical deterioration in geriatric in-patients with sinus rhythm or atrial fibrillation compared to placebo?
In geriatric inpatients without severe heart failure or rapid atrial fibrillation, withdrawal of digoxin (placebo phase) led to clinical deterioration in 14% of patients.
Supports caution against digoxin withdrawal in geriatric inpatients; confirms benefit versus placebo in preventing deterioration.
The effects of oral digoxin and placebo in 41 geriatric in-patients were compared using a randomized, double-blind, cross-over method. The patients were in sinus rhythm or had atrial fibrillation. The observation period was two months on digoxin or placebo. Patients with symptoms of cardiac failure at rest or during light physical activity, X-ray signs of pulmonary congestion, proven need of digoxin therapy following earlier withdrawal, atrial fibrillation with a ventricular rate greater than 95 beats/min and patients in whom digitalis intoxication was suspected were excluded from the study. Five (14%) of 37 patients deteriorated during the placebo phase. Four of these developed rapid atrial fibrillation and one patient developed sinus tachycardia and symptoms of heart failure.
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Kurt Boman (1983) studied this question.
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