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Digitalis: dead or alive?

Over 200 years age, William Withering described the advantages which might be gained by the considered use of extracts of the foxglove, digitalis purpurea, in patients with congestive heart failure, particularly if the rhythm was irregular. In the subsequent years many patients undoubtedly benefited from the use of this drug. The introduction of diuretics in the present century provided an alternative, more effective and safer treatment for heart failure. More recently, angiotensin-converting enzyme inhibitors have become available. The use of digoxin in the treatment of heart failure is now indicated almost solely for the control of a fast heart rate in patients with atrial fibrillation.