23. Which of the following is the best indication to use digoxin to lower ventricular rates in paroxysmal atrial fibrillation?

A. A structurally normal heart with fast heart rates despite non-dihydropyridine calcium channel blocker use

B. A structurally normal heart as first line therapy alone

C. Severe systolic dysfunction as first line therapy alone

D. Severe systolic dysfunction with fast heart rates despite beta-blocker

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