Role of digitalis in chronic congestive heart failure and sinus rhythm.

Whereas the use of digitalis in atrial fibrillation is universally accepted, its administration in patients in sinus rhythm for its inotropic properties has recently been questioned. The risk of digitalis administration is high and may be unavoidable because of the occurrence of changes in sensitivity to digitalis. Benefits of digitalis are poorly defined. Hemodynamically digitalis is a weak inotropic agent. Clinical improvement is difficult to detect; furthermore, the role of long-term maintenance digitalis therapy appears questionable, inasmuch as several studies failed to show deterioration after digitalis therapy has been discontinued.