Key result
Administration of Digoxin Immune Fab successfully resolved digoxin-induced bidirectional ventricular tachycardia, converting it to a stable paced rhythm within three hours.
Why the study?
Because digoxin is rarely used in modern cardiovascular management, digoxin toxicity is infrequently encountered and paramount to diagnose in a timely fashion.
Case Report (n=1)
Clinician awareness of rare EKG patterns of digoxin toxicity, such as bidirectional ventricular tachycardia, is crucial for timely treatment and resolution of fatal arrhythmias.
Digoxin is rarely used in modern cardiovascular disease management. Therefore, digoxin toxicity has been infrequently encountered and it is paramount to diagnose in a timely fashion. Bidirectional ventricular tachycardia is an unusual arrhythmia wherein every other beat has a different QRS axis as it travels alternately down different conduction pathways. The arrhythmia can be a manifestation of myocarditis, myocardial infarct, Andersen-Tawil syndrome, arrhythmogenic right ventricular cardiomyopathy, catecholaminergic polymorphic ventricular tachycardia, herbal aconite poisoning, and digoxin toxicity. This case illustrates the importance of clinician awareness of rare electrocardiogram (EKG) patterns of digoxin toxicity and visual resolution of fatal arrhythmia with timely treatment.
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Aung et al. (2021) conducted a case report in Digoxin toxicity with bidirectional ventricular tachycardia (n=1). Digoxin Immune Fab was evaluated on Rhythm conversion. Administration of Digoxin Immune Fab successfully resolved digoxin-induced bidirectional ventricular tachycardia, converting it to a stable paced rhythm within three hours.
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