De onbesliste rol van digoxine bij stabiel hartfalen en atriumfibrilleren

Introduction

The effects and dangers of digoxin were both described over 200 years ago. Today’s clinicians have a multitude of options for treating heart failure and atrial fibrillation. Is digoxin still one of them?

Discussion

This paper discusses the case of an 82-year-old patient with heart failure and atrial fibrillation. The Digitalis Investigation Group trial showed that digoxin reduces the risk of rehospitalisation but not mortality. Based on these findings, digoxin has been the cornerstone of heart failure treatment for years. Post-hoc analyses showed this benefit mostly in patients with lower serum levels. Even today, digoxin is still included in European cardiology guidelines and Dutch general practitioner guidelines.

Conclusion

The added value of digoxin on top of current treatment has not been properly investigated so far. To answer this issue, a multicentre RCT on the effects of digoxin will be conducted.

Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.