The use of digitalis in spite of the presence of ventricular tachycardia.

T HE presence of ventricular tachycardia has been regarded as one of the major contraindications to the use of digitalis.'-8 Our clinical observations, however, have led us to use digitalis somewhat more freely in cardiac disease in general than is usually recommended.9-10 The four observations on three patients presented in this paper illustrate instances of the intensive use of digitalis in the presence of ventricular tachycardia. It is not assumed that the digitalis in these instances stopped the tachycardia, but its use, along with other supportive measures, was followed by marked clinical improvement and the cessation of ventricular tachycardia. These results were not to be expected from the usual literature on digitalis or ventricular t achy(ardia.2-8 In our observations signs and symptoms which could be attributed to digitalis intoxication (nausea, vomiting, diarrhea and ventricular tachycardia) disappeared with the intensive use of digitalis, indicating that those signs, including the ventricular tachycardia, were not due to digitalis effect or to digitalis intoxication. Gratifying experiences'0 with the use of digitalis in patients with disabling ventricular premature beats, heart block, and with severe acute myocardial infarction, all rather commonly regarded as relatively unsuitable conditions for the use of digitalis, led to its use in the first case reported in this paper, when rapidly progressing heart failure seemed to demand