EFFECTS OF DIGOXIN ON TIME-DOMAIN MEASURES OF HEART-RATE-VARIABILITY IN PATIENTS WITH STABLE CHRONIC CARDIAC-FAILURE - WITHDRAWAL AND COMPARISON GROUP STUDIES

The effect on heart rate variability of adding digoxin to a diuretic a nd ACE inhibitor was studied in patients with chronic stable cardiac f ailure. Digoxin was found to increase heart rate variability, especial ly those measures of heart rate variability thought to represent paras ympathetic activity. The withdrawal of digoxin led to a decrease in he art rate variability to pre-treatment levels. Whilst digoxin in standa rd doses does not alter prognosis in chronic cardiac failure, it does have potentially beneficial neurohumoral effects. If the increase in h eart rate variability, which represents beneficial neurohumoral modula tion can be divorced from the potentially detrimental effects, perhaps by using smaller doses, then there may be a role for digoxin in the t reatment of chronic cardiac failure. (C) 1997 Elsevier Science Ireland Ltd.