[Relationship between digoxin-induced cardiac arrhythmias and serum-digoxin levels (author's transl)].
The serum-digoxin level was measured by radio-immunoassay (Immutope) on 245 patients in a coronary care unit. Cardiac arrhythmias were assumed to be digoxin-induced if they disappeared after the drug had been stopped. Patients who had received digitoxin or spironolactone were excluded. The results indicated a normal digoxin range of 1.52 +/- 0.2 ng/ml and a toxic one of 2.78 +/- 0.38 ng/ml. First degree A-V block, atrial ectopic beats and ventricular ectopics with variable coupling intervals were frequently associated with serum-digoxin levels of 1.5-2.5 ng/ml, while higher grade A-V block, atrial tachycardia, bigeminy and atrial tachycardia with block were more frequent with higher serum-digoxin levels (greater than 3.0 ng/ml). Atrial arrhythmias were especially frequent with serum levels above 3.0 ng/ml. This suggests different sensitivities of atrial and ventricular myocardium. Atrial arrhythmias thus in general indicate a higher degree of toxicity at high serum levels, while ventricular ectopic beats occur both with high serum levels and also with increased digoxin sensitivity of the ventricles.
D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D005117:Cardiac Complexes, Premature / Q000139:chemically induced; D003327:Coronary Disease / Q000503:physiopathology; D004077:Digoxin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000097:blood* / Q000506:poisoning; D006327:Heart Block / Q000139:chemically induced; D006801:Humans; D011863:Radioimmunoassay; D012016:Reference Values; D013610:Tachycardia / Q000139:chemically induced
D004077:Digoxin
Zusammenhang digoxinbedingter kardialer Arrhythmien mit dem Serumdigoxinspiegel