What is an indication for digoxin in patients with poor cardiac function?

The use of digoxin in patients with poor cardiac function is primarily indicated for its ability to help manage heart rate and improve cardiac output, especially in the context of heart failure and certain types of atrial fibrillation. One of its key effects is to slow down the heart rate by increasing vagal tone and decreasing conduction through the atrioventricular (AV) node, making it beneficial in patients with rapid ventricular rates due to atrial fibrillation. In this capacity, digoxin can prevent arrhythmias by helping to achieve a more stable heart rate, thus reducing the risk of further complications associated with irregular heart rhythms.

Furthermore, digoxin has a positive inotropic effect, which means it strengthens heart muscle contractions. This effect, while beneficial in improving symptoms of heart failure, is primarily tied to its role in rhythm control, as maintaining a regular rhythm is crucial for optimal cardiac function. Therefore, in the context of managing arrhythmias, digoxin’s ability to support the heart in both rate control and contractility is valuable for patients with compromised cardiac function.

This aligns with the broader understanding of digoxin's role in therapeutic protocols for managing heart failure and controlling heart rate in atrial fibrillation, making it particularly useful in this patient population.