Digoxin in Heart Failure

Abstract

Although two centuries of anecdotal clinical evidence support the use of cardiac glycosides for the treatment of heart failure, controversy has surrounded their efficacy and appropriate indications. Early in this century, two of the founders of the clinical discipline of cardiology, Sir James Mackenzie in London and Henry Christian in Boston, had sharply differing views that have tended to persist in the United Kingdom and the United States, respectively. Mackenzie advocated the use of digitalis only in patients with supraventricular tachyarrhythmias, such as atrial fibrillation, whereas Christian believed that “digitalis . . . has a striking effect on those changes . . .