Key result
Digitalis toxicity linked to rare double AV nodal rhythm and ventricular electrical alternans.
Why the study?
Digitalis-induced double atrioventricular nodal rhythm associated with ventricular electrical alternans had not been previously reported.
Case Report (n=1)
No
This case report highlights the rare presentation of double AV nodal rhythm with electrical alternans as a sign of digitalis intoxication in elderly patients.
May aid recognition of atypical digitalis toxicity in elderly patients; leaves open incidence and generalizability.
An instance of digitalis-induced double atrioventricular nodal rhythm associated with ventricular electrical alternans has been described. To the knowledge of the author, it is the first such combination reported. One atrioventricular nodal pacemaker (group A) produces non-paroxysmal atrioventricular nodal tachycardia and the other pacemaker (group B) produces atrioventricular escape rhythm with electrical alternans. The influence of digitalis and hypokalemia in relation to such cardiac arrhythmia has been discussed. The necessity of early recognition of digitalis intoxication in elderly patients who develop non-paroxysmal atrioventricular nodal tachycardia and atrioventricular nodal escape rhythm during digitalization has been emphasized. The appearance of electrical alternans in this case is thought to be related to digitalis intoxication.
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Edward K. Chung (1968) conducted a case report in Digitalis intoxication (n=1). Digitalis (digoxin) was evaluated on Development of double atrioventricular nodal rhythm with electrical alternans. A 72-year-old male developed a rare combination of digitalis-induced double atrioventricular nodal rhythm and ventricular electrical alternans, highlighting the need for early recognition of digitalis toxicity.
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