The role of furosemide alone and in combination with digoxin in the relief of symptoms of congestive heart failure.

Clinical and cardiovascular responses to drug therapy with furosemide were compared with those to furosemide plus digoxin in 15 heart patients with sinus rhythm admitted to the hospital for the management of congestive heart failure. Except for two patients in the group treated with furosemide alone, who required the addition of intravenous furosemide for more complete relief of symptoms, the responses to the two therapeutic regimens were not significantly different. One patient in the digoxin-treated group developed atrial fibrillation with frequent ventricular premature beats and transient runs of bigeminal rhythm typical of digitalis toxicity, which disappeared as the dose of digoxin was lowered. Side effects were otherwise considered to be minor and similar in the two groups. The results support the view that the indications for digoxin as a positive inotropic agent in patients with congestive heart failure need to be reevaluated.