The indications for digitalis glycosides in the treatment of congestiv
e heart failure with sinusrhythm have been disputed since early in thi
s century. In the last decade several well designed studies have been
published that have established the effectiveness of digitalis in this
condition. However, new groups of drugs have been introduced in the t
reatment of heart failure and have been compared with digitalis. Ibopa
mine appeared to be an effective alternative for digitalis in patients
with heart failure of low NYHA class. Because of their proven favoura
ble effect on patient survival, ACE inhibitors are replacing digitalis
as first-line drug-after diuretics-in the treatment of congestive hea
rt failure. In this review of the literature the present place of digi
talis in the treatment of heart failure is discussed.