Digoxin toxicity

Digoxin toxicity causes a variety of arrhythmias. It is classically associated with supraventricular tachycardias but a slow ventricular response, e.g. atrial tachycardia with 2:1 block. It may also cause sinus bradycardia, slow or regularised AF, AV blocks, PVCs or VT.

Digoxin toxicity should be separated from the normal digoxin effect that can occur in patients taking the expected dose of digoxin. The digoxin effect includes sagging ST segment depression, abnormal T waves (flat, inverted or biphasic) and a short QT.

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