[Use of digitalis in geriatrics: is it effective on the heart in sinus rhythm?].

The therapeutic activity of digitalis in cardiac failure is linked to its positive inotropic effect on the myocardium and its ability to control cardiac activity in atrial fibrillation. Chronic stimulation with digoxin in aged subjects with sinus rhythm, however, is of debatable utility Reference is made to a series of 35 subjects (mean age 76.5 yr) in sinus rhythm, 30 of whom had been taking digoxin for over 3 yr. Clinical and instrumental parameters were assessed and heart function was classified according to the NYHA arrangement. Subjects were randomly placed in two groups matched for sex, age and cardiac condition. The first group received digoxin, the second a placebo. No significant differences between the two groups were noted over a 3-month period. In keeping with the recent literature, it is felt that digitalis is not necessary for the dynamic cardiac control of aged subjects in sinus rhythm. In addition, it is suggested that hydrosaline retention in such subjects can be controlled by restriction of salt intake, rest and diuretics.