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The Electrocardiogram in Digitalis Intoxication

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What’s New in Electrocardiography

Abstract

Digitalis intoxication is one of the most common adverse drug reactions and continues to be frequently fatal. In the Netherlands approximately 2% of the population are regular users of the drug [1] and in 1976 digitalis was the eighth most frequently prescribed drug in the USA [2]. Approximately one-fifth of the patients entering a general medical ward of a North American hospital will receive digitalis during their stay in hospital [3, 4]. From 10% to 2096 of the patients treated with the drug show symptoms of digitalis intoxication with a lethality ranging from 3% to 4096 [3–13]. Mortality rate rises sharply when digitalis intoxication is not recognized and the drug continued [5, 6].

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References

  1. Lely AH, van Enter CHJ: Large scale digitoxin intoxication. Br Med J 3:737–740, 1970.

    Article  PubMed  CAS  Google Scholar 

  2. Gosselin RA: National prescription audit, 13th edn. Amblez PA, RA Gosselin, 1976, p 171.

    Google Scholar 

  3. Beller GA, Smith TW, Abelmann NH, et al: Digitalis intoxication: a prospective clinical study with serum level correction. N Engl J Med 284:989–997, 1971.

    Article  PubMed  CAS  Google Scholar 

  4. Shapiro S, Stone D, Lewis PG, et al: The epidemiology of digoxin: a study in three Boston hospitals. J Chronic Dis 22:361–371, 1969.

    Article  PubMed  CAS  Google Scholar 

  5. Church G, Schamroth L, Schwartz NL, et al: Deliberate digitalis intoxication: a comparison of the toxic effects of 4 glycoside preparations. Ann Intern Med 57:946–956, 1962.

    PubMed  CAS  Google Scholar 

  6. Dreifus LS, McKnight EH, Katz M, et al: Digitalis intolerance. Geriatics 18:494–502, 1963.

    Google Scholar 

  7. Dubnow MH, Burchell HB: A comparison of digitalis intoxication in two separate periods. Ann Intern Med 62:956–965, 1965.

    PubMed  CAS  Google Scholar 

  8. Fisch C, Knoebel SB: Recognition and therapy of digitalis toxicity. Prog Cardiovasc Dis 13:71, 1970.

    Article  PubMed  CAS  Google Scholar 

  9. Horwitz N, Wade OL: Intensive hospital monitoring of adverse reactions to drugs. Br Med J 7:531, 1969.

    Article  Google Scholar 

  10. Pick A, Igarashi M: Mechanism, differential diagnosis and clinical significance of digitalis induced arrhythmias. In: Fisch C, Sorawicz B (eds) Digitalis. New York, Grune and Stratton, 1969.

    Google Scholar 

  11. Resnick N: Digitalis: a double edged sword. Med Sci 15:31–38, 1964.

    PubMed  CAS  Google Scholar 

  12. Schölmerich P, Pabst K, Jahrreiss O, et al: Nebenwirkungen der Therapie mit Herzglycosiden. Dtsch Med Wochenschr 89:12–18, 1964.

    Article  Google Scholar 

  13. Chung EK: Incidence and types of digitalis-induced arrhythmias. In: Sandoe E, Flensted-Jensen E, Olesen HO (eds) Symposium and cardiac arrhythmias. AB Astra, Södertälje, Sweden, Elsevier, 1970, pp 613–629.

    Google Scholar 

  14. Williams JF Jr, Klocke FJ, Braunwald E: Studies on digitalis. 13. Comparison of the effects of potassium on the inotropic and arrhythmia-producing actions of ouabain. J Clin Invest 45:346–352, 1966.

    Article  PubMed  CAS  Google Scholar 

  15. Klein M, Nejad NS, Lown B, et al: Correlation of the electrical and mechanical changes in the dog heart during progressive digitalization. Circ Res 29:635–645, 1971.

    PubMed  CAS  Google Scholar 

  16. Mason DT, Lee G, Peng CL, et al: The digitalis inotropic dose-response curve: demonstration of linearity and attenuation by potassium. Circulation [Suppl 2] 46:30, 1972.

    Google Scholar 

  17. Lee G, Peng CL, Mason DT, et al: Similarity of the inotropic time course of differing digitalis preparations in isolated cardiac muscle [abstr]. Circulation [Suppl 2] 46:31, 1972.

    Google Scholar 

  18. Moe FI, Farah AE: Digitalis and allied cardiac glycosides. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. New York, Macmillan, 1955, p 689.

    Google Scholar 

  19. Smith TW, Haber E: Digitalis [third of four parts]. N Engl J Med 289:1063–1072, 1973.

    Article  PubMed  CAS  Google Scholar 

  20. Doherty JE, de Soyzan N, Kane JJ, Bissett JK, Murphy ML: Clinical pharmacokinetics of digitalis glycosides. Prog Cardiovasc Dis 21:141–158, 1978.

    Article  PubMed  CAS  Google Scholar 

  21. Butler VT, Lindenbaum J: Serum digitalis measurements in the assessment of digitalis resistance and sensitivity. Am J Med 58:460–469, 1975.

    Article  PubMed  CAS  Google Scholar 

  22. Lisaló E: Clinical pharmacokinetics of digoxin. Clin Pharmacokinet 2:1–16, 1977.

    Article  Google Scholar 

  23. Bigger JT, Strauss HC: Digitalis toxicity: drug interactions promoting toxicity and the management of toxicity. Semin Drug Treat 2:147–177, 1972.

    PubMed  CAS  Google Scholar 

  24. Smith TW, Butler VD, Haber E: Determination of therapeutic and toxic serum digoxin concentrations by radioimmunoassory. N Engl J Med 281:1212–1216, 1969.

    Article  PubMed  CAS  Google Scholar 

  25. Waldorff S, Andersen JD, Heeboll-Nielsen N, Nielsen OG, Moltke E, Sorensen V, Steiness E: Spironolactone-induced changes in digoxin kinetics. Clin Pharmacol Ther 24:162–167, 1978.

    PubMed  CAS  Google Scholar 

  26. Hager WD, Fenster P, Mayersohn M, Perrier D, Graves P, Marcus FI, Goldman S: Digoxin-quinidine interaction, pharmacokinetic evaluation. N Engl J Med 300: 1238–1241, 1979.

    Article  PubMed  CAS  Google Scholar 

  27. Doering W: Quinidine-digoxin interaction; pharmacokinetics, underlying mechanism and clinical implications. N Engl J Med 301:400–404, 1979.

    Article  PubMed  CAS  Google Scholar 

  28. Risler T, Peters V, Grabensee B, Seipel L: Untersuchungen zur Interaktion von Chinidin und Digoxin beim Menschen. Dtsch Med Wochenschr 104:1523–1526, 1979.

    Article  PubMed  CAS  Google Scholar 

  29. Leachy EB Jr, Reiffel JA, Heissenbuttel RH, et al: Enhanced cardiac effect of digoxin during quinidine treatment. Arch Intern Med 139:519–521, 1979.

    Article  Google Scholar 

  30. Pederson KE, Hvidt S: Quinidine-digoxin interaction [letter to the editor]. N Engl J Med 302:176–177, 1980.

    Google Scholar 

  31. Powell JR, Fenster PE, Hager WD, Graves P, Wandell M, Conrad K: Quinidine-digoxin interaction [letter to the editor]. N Engl J Med 302:176–177, 1980.

    PubMed  CAS  Google Scholar 

  32. Doherty J, Straub D, Bissett J, Kane J, de Soyza N, Murphy M: Digoxin-quinidine interaction: increased digoxin brain concentration [abstr]. Circulation [Suppl 2] 59 and 60:11–230, 1979.

    Google Scholar 

  33. Smith TW, Curfman GD, Green LH: The use and misuse of digoxin blood levels. In: Hurst JW (ed) The heart, update I. New York, McGraw-Hill, 1979, pp 75–82.

    Google Scholar 

  34. Withering W: An account of the foxglove and some of its medical uses with practical remarks on dropsy and other diseases. Birmingham, Robinson, 1785.

    Google Scholar 

  35. Gaultier M, Fournier E, Efthymiou ML, Frejaville JP, Jouannot P, Dentan M: Intoxication digitalique aiguë (70 observations). Bull Soc Med Hop Paris 119:247–274, 1968.

    PubMed  CAS  Google Scholar 

  36. Smith TW, Willerson JT: Suicidal and accidental digoxin ingestion. Circulation 44:29–36, 1971.

    PubMed  CAS  Google Scholar 

  37. Vassalle M, Karis J, Hoffman BF: Toxic effects of ouabain on Purkinje fibers. Am J Physiol 203:433–439, 1962.

    PubMed  CAS  Google Scholar 

  38. Hoffman BF, Singer DH: Effects of digitalis on electrical activity of cardiac fibers. Prog Cardiovasc Dis 7:226, 1964.

    Article  CAS  Google Scholar 

  39. Fisch C, Surawicz B: Digitalis. New York, Grune and Stratton, 1969.

    Google Scholar 

  40. Scherlag BJ, Abelleira JS, Narula OS, Samet PH: The differential effects of ouabain on sinus, A-V nodal, His bundle and idioventricular rhythms. Am Heart J 81:227–235, 1971.

    Article  PubMed  CAS  Google Scholar 

  41. Wittenberg SW, Gandel P, Hogan PM, Kreuzer W, Klocke FJ: Relationship of heart rate to ventricular automaticity in dogs during ouabain administration. Circ Res 30:167–176, 1972.

    PubMed  CAS  Google Scholar 

  42. Smith TW, Haber E: Digitalis [first of four parts]. N Engl J Med 289:945–952, 1973.

    Article  PubMed  CAS  Google Scholar 

  43. Mason DT, et al: Mechanisms of digitalis arrhythmias. Electro-physiologic and myocardial subcellular consideration. Dretfus LS, Likoff W (eds). New York, Grune and Stratton, 1973.

    Google Scholar 

  44. Rosen RM, Gelband H, Merker CH, Hoffman BH: Mechanisms of digitalis toxicity. Effects of ouabain on phase four of canine Purkinje fiber transmembrane potentials. Circulation 47:681–689, 1973.

    PubMed  CAS  Google Scholar 

  45. Ferrier GR, Saunders JH, Mendeg C: A cellular mechanism for the generation of ventricular arrhythmias by acetylstrophantidin. Circ Res 32:600–609, 1973.

    PubMed  CAS  Google Scholar 

  46. Cranefield PF, Aronson RS: Initiation of sustained rhythmic activity by single propagated action potentials in canine cardiac Purkinje fibers exposed to sodium-free solution or to ouabain. Circ Res 34:477–481, 1974.

    PubMed  CAS  Google Scholar 

  47. Rosen RM, Wit AL, Hoffman BF: Electrophysiology and pharmacology of cardiac arrhythmias. IV. Cardiac antiarrhythmic and toxic effects of digitalis. Am Heart J 89:391–399, 1975.

    Article  PubMed  CAS  Google Scholar 

  48. Banka VS, Scherlag BJ, Helfant RH: Contractile and electrophysiological responses to progressive digitalis intoxication. Cardiovasc Res 9:65–72, 1975.

    Article  PubMed  CAS  Google Scholar 

  49. Goodman DJ, Rosen RM, Cannom DS, Rider AK, Harrison DC: Effect of digoxin on atrioventricular conduction. Circulation 51:251–256, 1975.

    PubMed  CAS  Google Scholar 

  50. Ferrier GF: Digitalis arrhythmias: role of oscillatory afterpotentials. Prog Cardiovasc Dis 19:459–474, 1977.

    Article  PubMed  CAS  Google Scholar 

  51. Rosen RM, Danilo P: Effects of tetrodotoxin, Lidocaine, Verapamil and HR-2666 on ouabain-induced delayed afterdepolarisations in canine Purkinje fibers. Circ Res 46:117–124, 1980.

    PubMed  CAS  Google Scholar 

  52. Herrmann GR, Decherd GM Jr, McKinley WF: Digitalis poisoning. JAMA 126:760–762, 1944.

    Google Scholar 

  53. Flaxman N: Digitoxin poisoning. A report of 30 cases. Am J Med Sci 216:179–182, 1948.

    Article  PubMed  CAS  Google Scholar 

  54. Crough RB, Herrmann GR, Hejtmancik MR: Digitalis intoxication. Tex Med 52:714–719, 1956.

    Google Scholar 

  55. Schrager MW: Digitalis intoxication. AMA Arch Intern Med 100:881, 1957.

    Google Scholar 

  56. Friedberg CK, Donoso E: Arrhythmias and conduction disturbances due to digitalis. Prog Cardiovasc Dis 2:408–431, 1959.

    Article  Google Scholar 

  57. Von Capeller D, Copeland GD, Stern TN: Digitalis intoxication: clinical report of 148 cases. Ann Intern Med 50:869–878, 1959.

    Google Scholar 

  58. Rodensky PL, Wasserman F, Gables C: Observations on digitalis intoxication. Arch Intern Med 108:61–78, 1961.

    Google Scholar 

  59. Dreifus LS, Katz M, Watanabe Y, Likoff W: Clinical significance of disorder of impulse formation and conduction in the atrioventricular node. Am J Cardiol 11:384–391, 1963.

    Article  Google Scholar 

  60. Herrmann GR: Digitoxicity in the aged. Recognition frequency and management. Geriatrics 21:109–122, 1966.

    PubMed  CAS  Google Scholar 

  61. Chung EK: Digitalis-induced cardiac arrhythmias: a report of 180 cases. Jpn Heart J 10:409–427, 1969.

    Article  PubMed  CAS  Google Scholar 

  62. Fisch C, Knoebel SB: Recognition and therapy of digitalis toxicity. Prog Cardiovasc Dis 13:71, 1970.

    Article  PubMed  CAS  Google Scholar 

  63. Wellens HJJ: The electrocardiogram in digitalis intoxication. In: Yu PN, Goodwin JF (eds) Progress in cardiology 5. Philadelphia, Lea and Febiger, 1976, pp 271–290.

    Google Scholar 

  64. Hariman RJ, Krongrad E, Boxer RB, Weiss MB, Steeg CN, Hoffman BF: Method for recording electrical activity of the sinoatrial node and automatic atrial foci during cardiac catheterization in human subjects. Am J Cardiol 45:775–781, 1980.

    Article  PubMed  CAS  Google Scholar 

  65. Kaufman JG, Wachtel FW, Rothfield E, Bernstein A: The association of complete heart block and Adams-stokes syndrome in two cases of Mobitz type of block. Circulation 23:253–256, 1961.

    PubMed  CAS  Google Scholar 

  66. Phibbs B: Digitalis-induced arrhythmias. In: Phibbs B (ed) Cardiac arrhythmias, 2nd edn. 1973, pp 113–127.

    Google Scholar 

  67. Lewis T: Paroxysmal tachycardia. Heart 1:43, 1909.

    Google Scholar 

  68. MacKenzie J: Digitalis. Heart 2:273, 1911.

    Google Scholar 

  69. Lown B: Digitalis. Compiled and edited by Dimond EG. Springfield, Thomas 1957, p 187.

    Google Scholar 

  70. Lown B, Levine HD: Atrial Arrhythmias, digitalis and potassium. New York, Landsbergen Medical, 1958.

    Google Scholar 

  71. Lown B, Marcus F, Levine HD: Digitalis and atrial tachycardia with block. A year’s experience. N Engl. J Med 260:301–309, 1959.

    Article  PubMed  CAS  Google Scholar 

  72. Soffer A: The changing clinical picture of digitalis intoxication. Arch Intern Med 107:681–688, 1961.

    Google Scholar 

  73. Gallavardin L, et al: Special auricular tachycardia different from paroxysmal tachycardia and auricular flutter [abstr]. Third World Congress Cardiology, 1958.

    Google Scholar 

  74. Roth IR, Kish B: Mechanisms of irregular sinus rhythm in auriculo ventricular heart block. Am Heart J 36:257–276, 1948.

    Article  PubMed  CAS  Google Scholar 

  75. Rosenbaum MB, Lepeschkin E: Effects of ventricular systole on auricular rhythm in auriculo-ventricular block. Circulation 11:240–261, 1955.

    PubMed  CAS  Google Scholar 

  76. Moe GK, Childrens RW, Merideth J: An appraisal of “supernormal” A-V conduction. Circulation 38:5–28, 1968.

    PubMed  CAS  Google Scholar 

  77. Steinbeck G, Bonke FI, Alessie MA, Lammers WJ: The effects of ouabain on the isolated sinus node preparation of the rabbit studied with microelectrodes. Circ Res 46:406–414, 1980.

    PubMed  CAS  Google Scholar 

  78. Oram S, Resnekov L, Davies P: Digitalis as a cause of paroxysmal atrial tachycardia with atrioventricular block. Br Med J 2:1402–1409, 1960.

    Article  PubMed  CAS  Google Scholar 

  79. Alexander S, Ping WC: Fatal ventricular fibrillation during carotid sinus stimulation. Am J Cardiol 18:289–291, 1966.

    Article  PubMed  CAS  Google Scholar 

  80. Porus RL, Marius FL: Ventricular fibrillation during carotid sinus stimulation. N Engl J Med 268:1338–1342, 1963.

    Article  PubMed  CAS  Google Scholar 

  81. Greenwood RJ, Dupler DA: Death following carotid sinus pressure. JAMA 181:605–609, 1962.

    PubMed  CAS  Google Scholar 

  82. Chung KY, Thomas J: Arrhythmias created by digitalis. Geriatrics 20:1006–1015, 1965.

    PubMed  CAS  Google Scholar 

  83. Brest AN, Durge NG, Goldberg H: Conversion of atrial fibrillation to atrial flutter as a manifestation of digitalis toxicity. Am J Cardiol 6:682–684, 1961.

    Article  Google Scholar 

  84. Hauck AJ, Ongley PA, Nadas AS: The use of digoxin in infants and children. Am Heart J 56:443–457, 1958.

    Article  PubMed  CAS  Google Scholar 

  85. Irons GV, Orgain ES: Digitalis-induced arrhythmias and their management. Prog Cardiovasc Dis 8:539–569, 1966.

    Article  PubMed  Google Scholar 

  86. Icle IW: Clinically aspects of complete atrioventricular heart block: clinical analysis of 71 cases. Ann Intern Med 32:510–523, 1950.

    Google Scholar 

  87. Somlyo AP: The toxicology of digitalis. Am J Cardiol 5:523–533, 1960.

    Article  PubMed  CAS  Google Scholar 

  88. Katz LN, Pick A: Clinical electrocardiography. 1. The arrhythmia. Philadelphia, Lea and Febiger, 1956.

    Google Scholar 

  89. Bellet S: Clinical disorders of the heart beat. Philadelphia, Lea and Febiger, 1963.

    Google Scholar 

  90. Schwartz LS, Schwartz SP: The effect of digitalis bodies on patients with heart block and congestive heart failure. Prog Cardiovasc Dis 6:366–407, 1964.

    Article  PubMed  CAS  Google Scholar 

  91. Schwartz SP, Schwartz LS: The Adams-Stokes syndrome during normal sinus rhythm and transient heart block. Arch Intern Med 196:38–399, 1960.

    Google Scholar 

  92. Schwartz LS, Schwartz SP: Adams-Stokes syndrome during atrial fibrillation with AV block. Observations on toxic reactions to digitalis. Am J Cardiol 14:483–493, 1964.

    Article  PubMed  CAS  Google Scholar 

  93. Knoebel SB, Fisch Ch: Accelerated junctional escape. A clinical and electrocardiographic study. Circulation 50:151–158, 1974.

    PubMed  CAS  Google Scholar 

  94. Pick A, Dominguez P: Nonparoxysmal A-V nodal tachycardia. Circulation 16:1022–1032, 1957.

    PubMed  CAS  Google Scholar 

  95. Rabbino MD, Dreifus LS, Likoff W: Cardiac arrhythmias following intracardiac surgery. Am J Cardiol 7:681–689, 1961.

    Article  PubMed  CAS  Google Scholar 

  96. Fisch C, Knoebel SB: Junctional rhythms. Prog Cardiovasc Dis 13:141–158, 1970.

    Article  PubMed  CAS  Google Scholar 

  97. Rosenbaum M: Classification of ventricular extrasystoles according to form. J Electrocardiogr 2:289–298, 1969.

    Article  CAS  Google Scholar 

  98. Rosenbaum MB, Halpern MS, Nau GJ, Elizari MV, Lazzari JO: The mechanism of narrow ventricular ectopic beats. In: Sandoe E, Flensted-Jensen E, Olesen KH (eds) Symposium on cardiac arrhythmias. AB Astra, Sweden, 1970, pp 223–247.

    Google Scholar 

  99. Gooch AS, Natarajan G, Goldberg H: Influence of exercise on arrhythmias induced by digitalis therapy in patients with atrial fibrillation. Am J Cardiol 33:231–237, 1974.

    Google Scholar 

  100. Goldberg LM, Bristow JD, Parker BM, Ritzman LW: Paroxysmal atrial tachycardia with atrioventricular block: its frequent association with chronic pulmonary disease. Circulation 21:499–504, 1960.

    Google Scholar 

  101. Pick A: AV dissociation. A proposal for a comprehensive classification and consistent terminology [editorial]. Am Heart J 66:147–150, 1963.

    Article  PubMed  CAS  Google Scholar 

  102. Pick A, Langendorf R: Recent advances in the differential diagnosis of A-V junctional arrhythmias. Am Heart J 76:553–575, 1968.

    Article  Google Scholar 

  103. Rosen KM: Junctional tachycardia: mechanisms, diagnosis, differential diagnosis and management. Circulation 47:654–664, 1973.

    PubMed  CAS  Google Scholar 

  104. Wellens HJJ, Düren DR, Liem KL, Lie KI: Effect of digitalis in patients with paroxysmal atrioventricular nodal tachycardia. Circulation 52:779–788, 1975.

    PubMed  CAS  Google Scholar 

  105. Pick A: Langendorf R, Katz LN: AV nodal tachycardia with block. Circulation 24:12–22, 1961.

    PubMed  CAS  Google Scholar 

  106. Chevalier RB, Fisch C: Dissociation of pacemakers located within the atrioventricular node. Am J Cardiol 5:564–565, 1960.

    Article  PubMed  CAS  Google Scholar 

  107. Castellanos A Jr, Azan L, Calvino JM: Dissociation with interference between pacemakers located within the AV conducting system. Am Heart J 56:562–569, 1958.

    Article  Google Scholar 

  108. Castellanos A Jr, Lemberg J: The relationship between digitalis and atrioventricular nodal tachycardia with block. Am Heart J 66:605–613, 1963.

    Article  PubMed  Google Scholar 

  109. Chung K, Walsh TJ, Massie E: Double AV nodal rhythm. Jpn Heart J 5:171–179, 1964.

    Article  Google Scholar 

  110. Chung EK: Unusual form of digitalis induced triple AV nodal rhythm. Am Heart J 79:250–253, 1970.

    Article  PubMed  CAS  Google Scholar 

  111. Jonas S, Richman SM: Double nodal rhythm with A-V dissociation. Am Heart J 60:811–816, 1960.

    Article  PubMed  CAS  Google Scholar 

  112. Kristin AD: Atrioventricular premature and escape beats with altered QRS and fusion. Circulation 34:740–751, 1966.

    Google Scholar 

  113. Pick A: Aberrant ventricular conduction of escape beats. Preferential and accessory pathways in the A-V junction. Circulation 13:702–711, 1956.

    PubMed  CAS  Google Scholar 

  114. Walsh TJ: Ventricular aberration of AV nodal escape beats: comments concerning the mechanism of aberration. Am J Cardiol 10:217–222, 1962.

    Article  PubMed  CAS  Google Scholar 

  115. Massumi RA, Ertem GE, Vera Z: Aberrancy of junctional escape beats: evidence for origin in the left bundle branch. Am J Cardiol 29:351–359, 1972.

    Article  PubMed  CAS  Google Scholar 

  116. Cohen HC, Gozo EG Jr, Pick A: Ventricular tachycardia with narrow QRS complexes (left posterior fascicular tachycardia). Circulation 45:1035–1043, 1972.

    PubMed  CAS  Google Scholar 

  117. Sagal El, Wolff L: Digitalis bigeminy: analysis of 50 cases. N Engl J Med 240:676–680, 1949.

    Article  CAS  Google Scholar 

  118. Rosenbaum MB: Classification of ventricular extrasystoles according to form. J Electrocardiogr 2:298, 1969.

    Google Scholar 

  119. Rosenbaum MB, Elizari MV, Lazzari JO: The mechanism of bidirectional tachycardia. Am Heart J 78:4–12, 1969.

    Article  PubMed  CAS  Google Scholar 

  120. Cohen SI, Deissenrotz A, Hecht HS: Infra-His bundle origin of bidirectional tachycardia. Circulation 47:1260–1266, 1973.

    PubMed  CAS  Google Scholar 

  121. Morris SN, Zipes DP: His bundle electrocardiography during bidirectional tachycardia. Circulation 38:32–36, 1973.

    Google Scholar 

  122. Wittenberg SM, Streuli F, Klocke FJ: Acceleration of ventricular pacemakers by transient increases in heart rate in dogs during ouabain administration. Circ Res 26:705–716, 1970.

    PubMed  CAS  Google Scholar 

  123. Hogan PM, Wittenberg SM, Klocke FJ: Relationship of stimulation frequency to automaticity in the canine Purkinje fiber during ouabain administration. Circ Res 32:377–384, 1973.

    PubMed  CAS  Google Scholar 

  124. Castellanos A, Lemberg L, Centurion MJ, Berkovits BV: Concealed digitalis-induced arrhythmias unmasked by electrical stimulation of the heart. Am Heart J 73:484–490, 1967.

    Article  PubMed  Google Scholar 

  125. Lown B, Cannon RL, Rossi MA: Electrical Stimulation and digitalis drugs: repetitive response in diastole. Proc Soc Exp Biol Med 126:698–701, 1967.

    CAS  Google Scholar 

  126. Lown B: Electrical stimulation to estimate the degree of digitalization. Am Heart J 22:251–259, 1968.

    CAS  Google Scholar 

  127. Hagemeijer F, Lown B: Effect of heart rate on electrically induced repetitive ventricular responses in the digitalized dog. Circ Res 27:333–334, 1970.

    CAS  Google Scholar 

  128. Olgilvie RI, Ruedy J: An educational program in digitalis therapy. JAMA 222:50–55, 1972.

    Article  Google Scholar 

  129. Jelliffe RW, Buell J, Kalaba R: Reduction in digitalis toxicity by computer-assisted glycoside dose regimens. Ann Intern Med 77:891–906, 1972.

    PubMed  CAS  Google Scholar 

  130. Fisch CH, Stone JM: Recognition and treatment of digitalis toxicity. In: Fisch CH, Surawicz B (eds) Digitalis. New York, Grune and Stratton, 1969, pp 162–173.

    Google Scholar 

  131. Peleska B: Cardiac arrhythmias following condensor discharges and their dependence upon strength of current and phase of cardiac cycle. Circ Res 13:21, 1963.

    PubMed  CAS  Google Scholar 

  132. Strauss HC, Wyte RS, Ross SM, Hoffmann BF: Postcountershock arrhythmias in untreated and digitalized dogs. Circ Res 21:375, 1967.

    Google Scholar 

  133. Lown B, Kleiger R, Williams R: Cardioversion and digitalis drugs: changed threshold to electrical shock in digitalized animals. Circ Res 17:519–531, 1965.

    PubMed  CAS  Google Scholar 

  134. Beller BM, Kotler MN, Collens R: The use of ventricular pacing for suppression of ectopic ventricular activity. Am J Cardiol 25:467–473, 1970.

    Article  PubMed  CAS  Google Scholar 

  135. De Sanctis RW, Kastor JA: Rapid intracardiac pacing for treatment of recurrent ventricular tachyarrhythmias in the absence of heart block. Am J Cardiol 76:168–172, 1968.

    Google Scholar 

  136. Zelis R, Mason DT, Spann JF, Braunwald E: Effects of ventricular stimulation and potassium administration on digitalis induced arrhythmias. Am J Cardiol 25:428–433, 1970.

    Article  PubMed  CAS  Google Scholar 

  137. Hess T, Stucki P, Barandun S, Scholtysik G, Riesen W: Treatment of a case of lanatoside C intoxication with digoxin-specific F(ab02 antibody fragments. Am Heart J 98:767–771, 1979.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. E. J. Vanagt
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  2. H. J. J. Wellens
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Editors and Affiliations

  1. Department of Cardiology Annadal Hospital, University of Limburg, Maastricht, The Netherlands

    H. J. J. Wellens

  2. School of Medicine Division of Cardiology, University of Liège, Liège, Belgium

    H. E. Kulbertus

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© 1981 Martinus Nijhoff Publishers, The Hague

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Vanagt, E.J., Wellens, H.J.J. (1981). The Electrocardiogram in Digitalis Intoxication. In: Wellens, H.J.J., Kulbertus, H.E. (eds) What’s New in Electrocardiography. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-8239-0_16

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  • DOI: https://doi.org/10.1007/978-94-009-8239-0_16

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