Reevaluation of digitalis efficacy. New light on an old leaf.

Use of digitalis for the treatment of patients with congestive heart failure and sinus rhythm remains controversial. To ascertain the proper therapeutic role of digitalis, we have critically appraised the published clinical evidence of digitalis efficacy using standardized methodologic criteria. A search of the English literature from 1960 to 1982 identified 736 articles, of which 16 specifically addressed the clinical evaluation of digitalis therapy for patients with congestive heart failure and sinus rhythm. Only two double-blind, placebo-controlled trials provided clinically useful information. One study showed that digoxin therapy could be withdrawn successfully in elderly patients with stable congestive heart failure. The other showed that patients with chronic heart failure and an S3 gallop benefited from digoxin therapy.