PMID: 2503017Jun 1, 1989Paper

Clinical, haemodynamic, and pharmacological effects of withdrawal and reintroduction of digoxin in patients with heart failure in sinus rhythm after long term treatment

British Heart Journal
S E PughJ G Bloomfield

Abstract

A randomised, double blind, placebo controlled, crossover study of digoxin withdrawal and reintroduction was carried out over two periods of eight weeks each after long term treatment. Forty four patients with stable heart failure in sinus rhythm and plasma digoxin concentrations over 0.8 ng/ml were studied. Their progress was assessed by clinical criteria, by haemodynamic measurements (systolic time intervals and echocardiography), and by pharmacological measurements of erythrocytic sodium pump numbers and activity. After withdrawal of digoxin clinical deterioration occurred in only 25% of the patients. Furthermore, in only 9% of cases was digoxin reintroduction thought to be necessary. There was deterioration in only 11% of the patients during digoxin treatment. Deterioration during digoxin withdrawal was accompanied by changes in systolic time intervals, but similar, albeit smaller changes in systolic time intervals also occurred in patients with no deterioration. Deterioration was accompanied by changes in the pharmacological effects of digoxin on the erythrocytes, consistent with a loss of effect, and these changes did not occur in those who did not deteriorate. The occurrence of deterioration could not be predicted by any...Continue Reading

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Citations

Feb 1, 1994·Cardiovascular Drugs and Therapy·R W Campbell
Dec 1, 1993·Cardiovascular Drugs and Therapy·F I Marcus
Oct 1, 1993·Journal of the American College of Cardiology·R A Kelly, T W Smith
Nov 5, 1999·International Journal of Cardiology·A BabaS Ogawa
Jul 10, 1997·The New England Journal of Medicine·J SotoF G Vilchez
Oct 1, 1992·Australian and New Zealand Journal of Medicine·H D White
Nov 15, 1991·The American Journal of Cardiology·T R KimballD C Schwartz
Jun 4, 1992·The American Journal of Cardiology·M Gheorghiade, B J Zarowitz
Jun 28, 1997·Lancet·R W Campbell
Apr 29, 2015·Medwave·Carmen Rain, Gabriel Rada
Jun 17, 2015·Medwave·Carmen Rain, Gabriel Rada
Jun 24, 2004·Circulation·Shahbudin H Rahimtoola
Aug 30, 2001·European Journal of Clinical Investigation·G G BelzU Osowski
Apr 29, 2014·The Cochrane Database of Systematic Reviews·William B HoodJohn J V McMurray
May 1, 1993·British Heart Journal·C D ScottR S Bexton

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