Digoxin Withdrawal in Stable Heart Failure

Inclusion Criteria: 1. Over the age of 18 years 2. In sinus rhythm at the time of randomisation 3. Have a LVEF \<0.45 and a left ventricular end-diastolic dimension \>60 mm or \>34 mm/m2 4. Are receiving ACE inhibitor, β-blocker and diuretic therapy at the optimal doses. 5. Has been receiving digoxin therapy for at least 3 months at a dose that results in digoxin plasma levels of 0.4-0.8 on 2 consecutive blood tests (at least 1 weeks apart) prior to randomisation. The dose of digoxin must remain stable for at least 2 weeks prior to randomisation. 6. Documented, stable heart failure. Must have at least 1 of the following: * Hospitalised with a discharge diagnosed of heart failure in the last 6 months * Evidence of pulmonary congestion on chest X-ray * Evidence of heart failure on echocardiogram * Evidence of heart failure on ECG 7. Willing and able to provide informed consent Exclusion Criteria: 1. Systolic BP \>160mmHg or \<90mmHg 2. Diastolic BP \>95mmHg 3. Uncorrected primary valvular disease 4. Active myocarditis 5. Obstructive or restrictive Cardiomyopathy 6. Exercise capacity limited by other factors not including dyspnoea 7. Myocardial infarction within the previous 6 months 8. Stroke within the previous 12 months 9. Hospitalisation within one month of randomisation 10. A history of supraventricular arrhythmia or sustained ventricular arrhythmia 11. Claudication 12. Severe primary pulmonary (VC \<1.5L), renal or hepatic disease