THE ROLE OF DIGITALIS PREPARATIONS IN THE TREATMENT OF CARDIAC-FAILURE

While no doubt has ever been cast on the usefulness of digitalis in ca rdiac failure with atrial fibrillation and a fast ventricular rate, th ey are periodically brought into question regarding chronic cardiac fa ilure in sinus rhythm. While they have not been supplanted by new posi tive inotropic agents, they are in competition with converting enzyme inhibitors. Recent therapeutic trials have shown that digitalis prepar ations, alone or in association with converting enzyme inhibitors, hav e beneficial effects on symptoms and exercise duration in patients wit h symptomatic impaired left ventricular systolic function. While the e ffects of digitalis preparations on mortality remain unknown, a large North American study should soon provide an answer to this question.