Digoxin toxicity
Also calledDig toxicity · Digitalis toxicity · Digoxin poisoning · Digitalis intoxication
Definition
A clinical and electrophysiologic syndrome of digoxin excess whose cardiac hallmark is increased automaticity combined with impaired conduction. Characteristic arrhythmias combine a tachyarrhythmia with sinus or AV nodal suppression, such as atrial or junctional tachycardia with AV block, but sinus bradycardia, AV block of any degree and ventricular ectopy such as frequent premature ventricular beats are more common. Severe toxicity can cause ventricular tachycardia, which may be bidirectional, and ventricular fibrillation.
Clinical noteToxicity can occur even when the serum level is within the therapeutic range, especially with hypokalemia, hypomagnesemia or hypercalcemia.
Sources
- Ma G, Brady WJ, Pollack M, Chan TC. Electrocardiographic manifestations: digitalis toxicity. J Emerg Med. 2001;20(2):145-152. doi.org/10.1016/s0736-4679(00)00312-7
- Pincus M. Management of digoxin toxicity. Aust Prescr. 2016;39(1):18-20. doi.org/10.18773/austprescr.2016.006
- Andrews P, Anseeuw K, Kotecha D, Lapostolle F, Thanacoody R. Diagnosis and practical management of digoxin toxicity: a narrative review and consensus. Eur J Emerg Med. 2023;30(6):395-401. doi.org/10.1097/MEJ.0000000000001065
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.