digoxin and Electric-Injuries

Recently, digoxin use has been found to associate with higher mortality. Yet, potential mechanisms by which digoxin use increases mortality remain unclear. Increased arrhythmogenicity from digoxin use is one possibility. Thus, we aimed to evaluate the relation between digoxin and shock events in patients with implantable cardioverter defibrillators (ICDs).. We performed a retrospective chart review of all patients with ICDs and at least 1 device interrogation at our institution between January 1, 2012, and January 1, 2015. We aimed to cover 1 year of interrogation period. Patients with heart failure, atrial fibrillation, or both were included in the analysis. Patients were divided into 2 groups based on digoxin use, defined as use of digoxin for any period of time during ICD interrogation period. Incidence of ICD shock events and electrical storms and hospitalizations were compared between the 2 groups.. The study included 202 patients. Of those, 55 patients were on digoxin and 147 were not on digoxin. Patients on digoxin were more likely to receive ICD shocks (odds ratio [OR] = 2.5, 95% confidence interval [95% CI] = 1.01-6.18, P = .04) and have increased risk of electrical storms ( P = .02). Moreover, total hospitalizations were higher in digoxin users ( P = .02). Multivariate logistic regression analysis also showed that digoxin use was an independent predictor of shock events (OR = 4.07, 95% CI = 1.43-11.58, P = .009).. Digoxin is associated with increased shock events and electrical storms in patients with ICDs; however, large randomized controlled studies are needed to confirm our findings.

Topics: Aged; Cardiotonic Agents; Defibrillators, Implantable; Digoxin; Electric Countershock; Electric Injuries; Female; Heart Failure; Humans; Male; Middle Aged; Prosthesis Failure; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome

Electrical injury can cause a variety of cardiac arrhythmias. Atrial fibrillation as a result of such injury is fairly rare, however, and is rarer still in cases of low-tension electrical injury. We present the case of a patient who developed acute atrial fibrillation in association with low-voltage electrical injury, which resolved after the intravenous administration of digoxin.

Topics: Accidents, Occupational; Adult; Atrial Fibrillation; Digoxin; Electric Injuries; Electrocardiography; Humans; Infusions, Intravenous; Male