Can digoxin be given in hypertrophic cardiomyopathy?

Can digoxin be given in hypertrophic cardiomyopathy?

Low dose digoxin can be used to control ventricular rate in those with left ventricular ejection fraction less than 50%, having NYHA class II-IV symptoms and permanent atrial fibrillation (Class IIb, level of evidence C, 2014 European Society of Cardiology Guidelines)

Being an inotropic agent digoxin can enhance the left ventricular outflow tract obstruction. Even in those without LVOT obstruction, digoxin is not recommended, except in the specific subset mentioned above, that too only as a Class IIb recommendation.

Reference

1. Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014 Oct 14;35(39):2733-79.