Patients without chf or low ef lack the neurohormonal and inotropic derangements that may improve with digoxin, while remaining exposed to its potential deleterious effects such as proarrhythmia and bradycardia.

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because myocardial stunning may be present for weeks after an infarction, digoxin therapy should be avoided in the acute phase after myocardial infarction, unless its use is strongly indicated.


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