BACKGROUND Intravenous dobutamine administration improves short-term hemodynamics in patients with severe congestive heart failure (CHF). However, the clinical benefit of periodic administration remains controversial. OBJECTIVE To evaluate the efficacy of intermittent dobutamine administration in patients with refractory CHF. METHODS Nineteen patients with New York Heart Association class III/IV, ischemia-induced CHF participated in this double-blind, placebo-controlled study. All patients received intravenous dobutamine or placebo over a 24-hour period every 2 to 3 weeks for 6 months. They were also treated with angiotensin-converting enzyme inhibitors, digoxin, and diuretics. The number of admissions for CHF and mortality rate were compared. RESULTS Ten patients received dobutamine and nine received placebo. The pretreatment characteristics were similar in both groups. No statistically significant difference was observed between the number of admissions for CHF (p = 0.11). The median survival after enrollment was 7.97 months in the placebo group and 4.6 months in the dobutamine group. The Kaplan-Meier survival curves overlay, with no statistically significant difference between the treatment arms (p = 0.7). CONCLUSIONS Intermittent dobutamine infusions in patients with refractory CHF have no effect on the need for hospitalization or on survival.