DIGOXIN USE IN PATIENTS AWAITING HEART-TRANSPLANTATION FOR SYSTOLIC LEFT-VENTRICULAR FAILURE

We reviewed the drug therapy of 83 patients who underwent cardiac tran splantation for chronic left ventricular cardiac failure in Scotland f rom 1992-1996. Digoxin had been prescribed to 52% of patients in sinus rhythm, and 82% of those in atrial fibrillation (P=NS). This audit co nfirms that, in line with the clinical practice in the period between 1992 and 1996, digoxin was not widely used in patients with advanced c hronic heart failure who were in sinus rhythm. The publication of the withdrawal trials in 1993 might have been expected to increase the use of digoxin but this could not be demonstrated. The management of pati ents on the cardiac transplantation waiting list should include the be st symptomatic treatment possible. In view of the clinical and experim ental evidence of symptomatic improvement by cardiac glycosides, it is to be hoped that publication of the results of the Digitalis Investig ation Group trial will improve this situation. (C) 1998 Elsevier Scien ce Ireland Ltd.