Digoxin defended: why make a SHIFT to ivabradine?

Following publication of the 2016 update to the American College of Cardiology Foundation / American Heart Association guidelines for the management of patients with heart failure, there’s been growing interest in the use of ivabradine, particularly to reduce the risk of rehospitalization for heart failure. But haven’t we had access to an agent that prevents heart failure rehospitalizations for a long time now? In this entry, we’ll explore how digoxin can fill an important niche in the management of patients with heart failure who remain at high risk for readmission despite optimal guideline-directed medical therapy.