ACC.26 – Late-breaker host Dr Harriette Van Spall (McMaster University, Hamilton, CA) is joined onsite by Dr Ganesan Karthikeyan (All India Institute of Medical Sciences, New Delhi, IN) to discuss the Dig-RHD trial.  

Dig-RHD is the first randomised trial of digoxin in patients with rheumatic heart disease and heart failure symptoms, designed to clarify its effects on symptom control, hospitalisation and survival in a population where rheumatic valve disease remains highly prevalent. The study specifically addresses long-standing uncertainty around digoxin use in low- and middle-income settings, where the drug is widely prescribed yet supported by limited and sometimes conflicting evidence, and explores how contemporary data should shape clinical practice.  

The discussion focuses on practical, bedside implications for clinicians managing rheumatic heart disease, including when and how to use digoxin, how to balance its potential benefits against risks such as toxicity and arrhythmia, and how these findings may influence future guideline recommendations and everyday decision-making in resource-constrained environments.  

Editor: Mirjam Boros  
Video Specialist: David Ben-Harosh, Tom Green

Support: This is an independent discussion produced by Radcliffe Cardiology.    

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