Electrocardiographic manifestations: digitalis toxicity

J Emerg Med. 2001 Feb;20(2):145-52. doi: 10.1016/s0736-4679(00)00312-7.


Toxicity from the digitalis family of cardiac glycoside medications remains common. Successful treatment depends on early recognition; however, the diagnosis of potentially life-threatening toxicity remains difficult because the clinical presentation is often nonspecific and subtle. The hallmark of cardiac toxicity is increased automaticity coupled with concomitant conduction delay. Though no single dysrhythmia is always present, certain aberrations such as frequent premature ventricular beats, bradydysrhythmias, paroxysmal atrial tachycardia with block, junctional tachycardia, and bidirectional ventricular tachycardia are common. Treatment depends on the clinical condition rather than serum drug level. Management varies from temporary withdrawal of the medication to administration of digoxin-specific Fab fragments for life-threatening cardiovascular compromise.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Arrhythmia Agents / poisoning*
  • Arrhythmias, Cardiac / chemically induced*
  • Cardiotonic Agents / poisoning*
  • Digitalis Glycosides / poisoning*
  • Electrocardiography*
  • Female
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use
  • Male
  • Middle Aged
  • Poisoning / diagnosis
  • Poisoning / physiopathology
  • Poisoning / therapy


  • Anti-Arrhythmia Agents
  • Cardiotonic Agents
  • Digitalis Glycosides
  • Immunoglobulin Fab Fragments