Digoxin is used for people who have symptoms of heart failure caused by left ventricular systolic dysfunction while they are receiving standard therapy (angiotensin-converting enzyme [ACE] inhibitors, beta-blockers, and diuretics). Digoxin is one of the oldest drugs in cardiovascular medicine, and it was traditionally used in patients with atrial fibrillation (AF) and heart failure (HF). 1 In the last 20 years, the use of this drug has markedly declined, and in the most recent 2012 European Society of Cardiology (ESC) HF Guidelines, 2 it is stated that for patients with HF and a left ventricular ejection fraction (LVEF. Aims. In the Digitalis Investigation Group (DIG) trial, digoxin reduced mortality or hospitalization due to heart failure (HF) in several pre-specified high-risk subgroups of HF patients, but data on protocol-specified 2-year outcomes were not presented. La digoxine est un glycoside cardiotonique extrait de la feuille de la digitale laineuse. Il fait partie de la classe des digitaliques. Elle est utilisée dans le traitement de diverses affections du cœur, mais son indication tend à se restreindre. Summary. The use of digitalis in congestive heart failure with normal sinus rhythm is still debated. While older uncontrolled, withdrawal studies from 1969 to 1983 provided incomplete data, with poorly documented clinical status and poor haemodynamic and exercise data, some patients did improve clinically when digitalis treatment was utilised. There is evidence to suggest that digoxin may be useful for managing symptoms of congestive heart failure in the palliative care setting. The authors describe two cases to illustrate the use of digoxin in end-stage heart failure with the goal of achieving better symptom control while managing the potential for digoxin toxicity. Patient factors potentially influencing digoxin concentrations in this case include hypothyroidism, congestive heart failure, and an acute episode of renal impairment, which might have been exacerbated by the use of celecoxib. Drug interactions with digoxin in this case include celecoxib, furosemide, levothyroxine, and spironolactone. The decision to continue digoxin in this patient is. Digoxin Reduces 30-Day All-Cause Hospital Admission in Ambulatory Older Patients with Chronic Heart Failure and Reduced Ejection Fraction Ali Ahmed, Mihai Gheorghiade, Gregg Fonarow, Kanan Patel, ESC GUIDELINES ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 The Task Force for the Diagnosis and Treatment of Acute and Effect of maintenance digoxin therapy on aerobic performance and exercise left ventricular function in mild to moderate heart failure due to coronary artery disease: a randomized, placebo-controlled, crossover trial. J Am Coll Cardiol 1991; 17:743.