An article from the New England Journal of Medicine (Volume 394, Issue 1, Pages 96-98, January 1, 2026) discusses the use of digitoxin in patients with heart failure and reduced ejection fraction (HFrEF). The DIGIT-HF study is a randomized, double-blind, placebo-controlled trial conducted in Germany and Austria in patients with advanced chronic HFrEF on optimal therapy. The aim is to assess the therapeutic potential and safety of digitoxin. Digitoxin is similar to digoxin, which according to post-hoc analyses of the DIG study reduces mortality by 19-23% at serum concentrations of 0.5-0.9 ng/ml in NYHA II-IV patients. Discontinuation of digoxin leads to decreased ejection fraction (p=0.001), increased body weight (p<0.001) and higher incidence of treatment failure (39% vs. 19%, p=0.039). Continuation of treatment maintained a higher ejection fraction (p=0.016)[1].