Heart failure is a chronic condition in which the heart fails to function as a pump to move
blood around the body. This sets up a complex physiologic response to compensate, which
include activation of many hormonal mechanisms which result in fluid accumulation.
In recent years, medications to block the hormonal response to heart failure are given as
standard drugs, and these include ACE inhibitors, and beta blockers. Mortality is reduced
with these medications, as well as symptoms improved.
Medications that were traditionally used in heart failure include diuretics, which cause
fluid loss, and digoxin, which causes the heart to pump harder. These medications were
introduced before clinical trials as we know them now were run. Since the introduction of ACE
inhibitors and beta blockers, it is not clear whether there is still a role for digoxin.
In this study, we plan to withdraw digoxin from patients with stable heart failure in normal
rhythm, taking stable doses of ACE inhibitors and beta blockers, in a closely monitored
environment and watch for the effect of this on heart failure.