Digoxin most effective in advanced disease
Heart failure occurs when the muscle loses its pumping ability. Digoxin is typically administered for systolic disfunction, not diastolic dysfunction, and is most beneficial to the patients with the most advanced heart failure.
• Digoxin is more effective in low output (pump) failure than in high output heart failure secondary to arteriovenous fistula, anemia, infection, or hyperthyroidism.
• In atrial fibrillation, the drug reduces ventricular rate and improves hemodynamics.
• Palpitation, precordial distress, or weakness are relieved, and concomitant congestive failure ameliorated. In atrial flutter, Digoxin slows the heart and affects regular sinus rhythm.
• The drug may convert paroxysmal atrial tachycardia to sinus rhythm by slowing conduction through the AV node.
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