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Related Experiment Videos

Relation between serum digoxin concentration and the electrocardiogram.

H E Saner1, H W Lange, C A Pierach

  • 1Cardiology Section, Abbott Northwestern Hospital, Minneapolis, Minnesota.

Clinical Cardiology
|November 1, 1988
PubMed
Summary
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Computerized electrocardiogram analysis reveals ST segment changes correlate with serum digoxin levels. Severe ST depression indicates higher digoxin concentrations, aiding patient management.

Area of Science:

  • Cardiology
  • Clinical Pharmacology
  • Medical Technology

Background:

  • Digoxin is a crucial medication for heart failure and arrhythmias.
  • Monitoring serum digoxin concentration is vital for therapeutic efficacy and toxicity prevention.
  • Electrocardiogram (ECG) changes can reflect digoxin's effects on the heart.

Purpose of the Study:

  • To assess the relationship between serum digoxin levels and specific electrocardiogram (ECG) parameters.
  • To determine if computerized ECG analysis can predict digoxin concentration.
  • To evaluate the clinical utility of ECG in managing digitalis therapy.

Main Methods:

  • Correlated computerized ECG measurements (PR, QRS, QT, QTc, ST segment, T-wave amplitude) with serum digoxin levels.
  • Studied 97 patients on digoxin maintenance therapy and 40 controls.

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  • Excluded patients with confounding cardiac conditions or medications.

    • Main Results:

    • A trend towards prolonged PR and shortened QT/QTc intervals was observed in digitalized patients.
    • Increasing serum digoxin concentrations correlated with progressive ST segment depression and decreased T-wave amplitude.
    • Severe ST depression (≥100 microV) accurately predicted digoxin levels >2.0 ng/ml (99% specificity).

    Conclusions:

    • Computerized ST segment analysis on ECG can provide clinically useful information for digoxin therapy management.
    • ECG analysis can help predict higher serum digoxin concentrations in a subset of patients.
    • This approach may enhance the diagnostic value of the ECG in digitalis-treated patients.