Lack of efficacy of digoxin in treatment of compensated congestive heart failure with third heart sound and sinus rhythm in elderly patients receiving diuretic therapy

Aronow, Wilbert S.; Starling, Laurence; Etienne, Fritzner

doi:10.1016/0002-9149(86)90264-x

Cited by 22 publications

(5 citation statements)

References 6 publications

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“…Digoxin can often be withdrawn without clinical deterioration in older patients with compensated CHF and sinus rhythm and abnormal LV ejection fraction 15,16 . Digoxin should not be used in treating patients with CHF and normal LV ejection fraction if sinus rhythm is present 2,17 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Appropriate and Inappropriate Indications for Use of Digoxin in Older Patients at the Time of Admission to a Nursing Home

Aronow

1996

J American Geriatrics Society

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Section: Discussionmentioning

confidence: 99%

Prevalence of Appropriate and Inappropriate Indications for Use of Digoxin in Older Patients at the Time of Admission to a Nursing Home

Aronow

1996

J American Geriatrics Society

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“…On the basis of these data, the author recommends administering digoxin to older persons with CHF in sinus rhythm associated with an abnormal LVEF who do not respond to diuretics plus ACE inhibitors and in those persons who are unable to tolerate ACE inhibitors or isosorbide dinitrate plus hydralazine. Digoxin can often be withdrawn from older persons with compensated CHF in sinus rhythm with abnormal LVEF without clinical deterioration 23,24 …”

Section: Digoxinmentioning

confidence: 99%

Congestive Heart Failure in Older Persons

1997

J American Geriatrics Society

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Left ventricular ejection fraction (LVEF) should be measured in all older persons with CHF. Underlying causes of CHF should be treated when possible. Precipitating causes of CHF should be treated. Older persons with CHF associated with an abnormal LVEF should be treated with a low sodium diet and with diuretics plus angiotensin-converting enzyme (ACE) inhibitors. If CHF persists, digoxin should be added to the therapeutic regimen. If CHF still persists, isosorbide dinitrate plus hydralazine should be added. If CHF still persists, a beta blocker should also be used. Calcium channel blockers should not be used. Older persons with CHF associated with a normal LVEF should be treated with a low sodium diet and with diuretics plus ACE inhibitors. If CHF persists, a beta blocker or isosorbide dinitrate plus hydralazine or a calcium channel blocker should be added to the therapeutic regimen. If sinus rhythm is present, digoxin should not be used. The role of angiotensin II receptor antagonists such as losartan in the treatment of CHF is under investigation.

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“…Until data from this study are available, I recommend using digoxin for treating elderly patients with CHF in sinus rhythm with abnormal LVEF that does not respond to diuretics plus ACE inhibitors or in patients unable to tolerate ACE inhibitors or other vasodilator therapy. Digoxin can often be withdrawn without clinical deterioration in elderly patients with compensated CHF in sinus rhythm with abnormal LVEF 17,18 .…”

Section: Therapymentioning

confidence: 99%

Lack of efficacy of digoxin in treatment of compensated congestive heart failure with third heart sound and sinus rhythm in elderly patients receiving diuretic therapy

Cited by 22 publications

References 6 publications

Prevalence of Appropriate and Inappropriate Indications for Use of Digoxin in Older Patients at the Time of Admission to a Nursing Home

Prevalence of Appropriate and Inappropriate Indications for Use of Digoxin in Older Patients at the Time of Admission to a Nursing Home

Congestive Heart Failure in Older Persons

Echocardiography Should Be Performed in All Elderly Patients with Congestive Heart Failure*

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