Effects of oral digoxin on ventricular ectopy and its relation to left ventricular function

Area of Science:

• Cardiology
• Pharmacology
• Electrophysiology

Background:

• Chronic ventricular ectopy poses a risk for adverse cardiovascular events.
• Oral digoxin is a commonly used medication with known antiarrhythmic properties.
• The efficacy of digoxin in suppressing ventricular arrhythmias, particularly in relation to left ventricular function, requires further elucidation.

Purpose of the Study:

• To evaluate the ventricular antiarrhythmic effects of oral digoxin in patients with chronic ventricular ectopy.
• To assess the impact of digoxin on premature ventricular complex frequency and complex ventricular arrhythmia patterns.
• To investigate whether left ventricular (LV) function influences digoxin's antiarrhythmic efficacy.

Main Methods:

• A randomized, placebo-controlled study involving 13 patients with chronic ventricular ectopy.
• Serial 24-hour electrocardiographic monitoring to quantify premature ventricular complex (PVC) frequency.
• Radionuclide left ventricular (LV) ejection fraction measurement to assess global LV performance.
• Administration of oral digoxin at doses of 0.25 mg and 0.375 mg daily.

Main Results:

• Oral digoxin significantly reduced mean premature ventricular complex (PVC) frequency at a dose of 0.375 mg/day (p < 0.05).
• Digoxin did not significantly alter the occurrence of complex ventricular arrhythmia patterns.
• In patients with normal LV ejection fraction (>50%), digoxin significantly decreased PVC frequency (p < 0.05) and couplet frequency (p < 0.04).
• No significant antiarrhythmic effects were observed in patients with depressed LV function.

Conclusions:

• Oral digoxin demonstrates moderate efficacy in suppressing premature ventricular complexes.
• The antiarrhythmic benefits of digoxin are more pronounced in patients with preserved left ventricular function.
• Digoxin may be a valuable therapeutic option for managing ventricular ectopy, especially in patients without significant systolic dysfunction.