<prompt> Which of the following is false about DigoxinDosage reduction is required in hepatic diseaseDosage direction is required in renal failureIt can cause bradycardiaIt increases the force of contraction in congestive hea failure  <response>: Refer kDT 7e p516.. Medical useEdit Irregular heabeatEdit The most common indications for digoxin are atrial fibrillation and atrial flutter with rapid ventricular response, though beta blockers andor calcium channel blockers are often preferred. There is tentative evidence that digoxin may increase the risk of death, though another meta-analysis in 2015 repoed no change in moality. Hea failureEdit Digoxin is no longer the first choice for hea failure; it has fallen out of or in people with hea failure because it may increase the risk of death. Currently, the recommendation for hea failure is a triple therapy of ACE inhibitor, beta blocker and mineralocoicoid antagonists. Digoxin is a third-line therapy. AboionEdit Digoxin is also used intrafetally or amniotically during aboions in the late second trimester and third trimester of pregnancy. It typically causes fetal demisemeasured by cessation of cardiac activity within hours of administration. Side effectsEdit Main aicle: List of side effects of digoxin Fuher information: Digoxin toxicity The occurrence of adverse drug reactions is common, owing to its narrow therapeutic index the margin between effectiveness and toxicity. Gynaecomastia enlargement of breast tissue is mentioned in many textbooks as a side effect, thought to be due to the estrogen-like steroid moiety of the digoxin molecule, but when systematically sought, the evidence for this is equivocal as of 2005. The combination of increased atrial arrhythmogenesis and inhibited atrioventricular AV conduction for example paroxysmal atrial tachycardia with AV block - so-called PAT with block is said to be pathognomonicthat is, diagnostic of digoxin toxicity. 