Efficacy and safety of low-dose digoxin in patients with heart failure. Rationale and design of the DECISION trial.

Aims: Digoxin is the oldest drug in cardiovascular (CV) medicine, and one trial conducted >25 years ago showed a reduction in heart failure (HF) hospitalizations but no effect on mortality. However, later studies suggested that the dose of digoxin used in that trial (and other studies) may have been too high. The DECISION (Digoxin Evaluation in Chronic heart failure: Investigational Study In Outpatients in the Netherlands) trial will examine the efficacy and safety of low-dose digoxin in HF patients with reduced or mildly reduced left ventricular ejection fraction (LVEF) with a background of contemporary HF treatment.

[Anticoagulation useful in short episodes of atrial fibrillation?].

In patients with short episodes of clinical, non-triggered AF is the evidence for long-term anticoagulation based on the CHA2DS2-VASc score strong. In situations where a temporary trigger for AF is observed (e.g.

[Beta-blockers after a myocardial infarction: when to discontinue safely?].

For decades beta-blockers have been used in the treatment of patients after a myocardial infarction (MI). Current guidelines on the use of beta-blockers after myocardial infarction are based on studies that date back to 3 decades ago. Since then advances in the treatment of myocardial infarction have been made, thanks to the implementation of percutaneous coronary intervention, statins and ACE-inhibitors.

Performance of idarucizumab as antidote of dabigatran in daily clinical practice.

Aims: Because practice-based data on the usage of idarucizumab for urgent dabigatran reversal is unavailable, we evaluated the appropriateness of idarucizumab usage, its haemostatic effectiveness and clinical outcomes.

Methods And Results: An observational cohort study was performed including consecutive patients who were treated with idarucizumab between 2016 and 2018. Appropriate usage was assessed with predefined criteria.

Symptom severity is associated with cardiovascular outcome in patients with permanent atrial fibrillation in the RACE II study.

Aims: Symptoms and symptom burden have a central place in diagnosis and management of atrial fibrillation (AF). The aim of the present study is to investigate whether severity of AF symptoms impacts prognosis in permanent AF.

Methods And Results: We studied the relation between AF symptom severity [quantified with the Toronto AF Severity Scale (AFSS)] and cardiovascular outcome in patients included in the RACE II study.