Does digoxin have a place in the treatment of the child with congenital heart disease?

Cardiovascular Drugs and Therapy
A N RedingtonE A Shinebourne

Abstract

The place of digoxin in the pediatric cardiologist's armamentarium remains uncertain. As an antiarrhythmic, its use in the Wolff-Parkinson-White syndrome is obsolete, but it remains useful in the treatment of the chronic atrial fibrillation seen in some patients postoperatively and in children with dilated cardiomyopathy. The efficacy of digoxin in heart failure is unproven. There is some evidence of improvement in non invasive left ventricular contractile indices in neonates and infants, but it is unclear whether this is associated with sustained clinical improvement. There is even less evidence of its effectiveness in the older child. Whilst the measurement of any effect will undoubtedly be difficult, the time has come for double-blind, placebo-controlled trials in selected groups of patients. These should be designed not only to test the notion that digoxin does not improve ventricular function, but also to embrace the possibility that its administration may result in clinical improvement over and above that following diuretics alone. An absence of proof of efficacy must be distinguished from no efficacy--more data are needed.

References

Jan 1, 1977·Clinical Pharmacokinetics·G Wettrell, K E Andersson
Mar 1, 1987·Archives of Disease in Childhood·J A TillD E Ward
Jan 1, 1985·The Journal of Pediatrics·B S AlpertW J Taylor
Feb 1, 1972·Pediatric Clinics of North America·L F Soyka
Feb 17, 1983·The New England Journal of Medicine·W BermanD Christensen
Apr 1, 1984·Pediatric Cardiology·A R HastreiterE Chow-Tung
Aug 11, 1983·The New England Journal of Medicine·M H LeBlanc
May 1, 1983·Acta paediatrica Scandinavica·B P Lundell, L O Boréus

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Citations

Dec 15, 2000·Progress in Pediatric Cardiology·T J Hougen
Nov 3, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Melanie D EverittAnji T Yetman
Feb 18, 2003·Intensive Care Medicine·Jens Christian MöllerUNKNOWN Surfactant ARDS Study Group
Oct 24, 2021·The Annals of Thoracic Surgery·Tyler N BrownJeffrey B Anderson

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