Why the study?
Do serum and myocardial digoxin concentrations correlate with electrocardiographic estimation of digoxin intoxication?
Do serum and myocardial digoxin concentrations correlate with electrocardiographic estimation of digoxin intoxication?
Serum and myocardial digoxin levels trend higher in patients with ECG evidence of digoxin toxicity, but significant overlap exists with non-toxic patients.
Serum digoxin levels should not guide toxicity assessment; leaves open prospective validation of concentration thresholds.
Serum and myocardial digoxin levels were studied in 18 patients who came to autopsy. An independent analysis of electrocardiograms prior to death was made to ascertain the relationship between serum and tissue levels of digoxin and clinical estimation of drug toxicity. Patients with arrhythmias of digoxin toxicity had higher mean serum and tissue digoxin levels than patients without arrhythmia. There was overlap in the patient groups, however, and the differences were not statistically significant. The tissue to serum ratio was lower in the toxic patients. The latter phenomenon is unexplained but may be related to decreased tissue binding.
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Biddle et al. (1978) studied this question.
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