Does digoxin still have a role in congestive heart failure?

The role of digoxin in the treatment of congestive heart failure is (CHF) being questioned. Digoxin continues to be the drug of choice for patients with atrial fibrillation in CHF. Large randomised trials have shown that digoxin (in addition to ACE inhibitors and diuretic) is beneficial in CHF due to systolic dysfunction, although it does not reduce mortality. Limited data suggest that digoxin benefit some, but not all patients with CHF due to left to right shunts. Digoxin does not benefit CHF due to diastolic dysfunction and it is not routinely recommended for prematures with patent ductus and CHF. The treatment with digoxin should be individualised.