Atrial fibrillation with Slow Ventricular response as a sign of Digoxin toxicity Secondary to Acute Renal failure.

Abstract

Digoxin is a cardiac glycoside that has been used for centuries for atrial fibrillation (AFib) and congestive heart failure (CHF). Digoxin has a narrow therapeutic index with a potential for toxicity that can be life-threatening^1-5. Toxicity can result from accidental or intentional overdose, renal failure, and/or hypokalemia. Cardiac manifestations of digoxin toxicity cause dysrhythmias of different types^2,6. Bidirectional ventricular tachycardia is a specific dysrhythmia in the setting of digitalis toxicity, but AFib with slow ventricular response (SVR) is another digoxin toxicity-related dysrhythmia⁷. Here, we report AFib with SVR as a sign of digoxin toxicity secondary to acute renal failure (ARF).