digoxin and Potassium-Deficiency

Reviews of large series of patients with digitalis-induced arrhythmias create a seeming paradox: Hypokalemia is infrequently associated with digitalis-induced arrhythmias but the clinical benefit of supplementation of potassium for most digitalis-induced arrhythmias is obvious. Examination of the electrophysiologic abnormalities induced by digitalis coupled with the electrophysiologic effects dependent on the ratio intracellular to extracellular concentrations of potassium clarifies the issue. We present evidence that supports additive effects of the toxicity of digitalis and abnormal ratios of concentrations of potassium inside and outside the cardiac cell. We provide guidelines for assessing this crucial ratio of intracellular to extracellular concentrations of potassium to aid the clinician in the diagnosis and effective treatment of digitalis-induced arrhythmias.

Topics: Adult; Aged; Alkalosis; Arrhythmias, Cardiac; Digoxin; Female; Humans; Male; Middle Aged; Potassium; Potassium Deficiency; Prospective Studies

Topics: Aminophylline; Digitalis Glycosides; Digoxin; Diuretics; Heart Failure; Heart Rate; Humans; Hypokalemia; Hyponatremia; Intermittent Positive-Pressure Breathing; Mineralocorticoid Receptor Antagonists; Oxygen; Potassium Deficiency; Pulmonary Edema; Tachycardia; Thyroid Diseases

Twelve patients with congestive heart failure receiving maintenance therapy with digoxin and potent diuretics were followed closely during development of hypokalemia and potassium loss. Cardiac arrhythmias compatible with digoxtin toxicity developed in 6 patients in the presence of stable, normal serum digoxin concentrations. The mechanisms involved in the development of the rhythm disturbances are discussed with regard to hypokalaemia, intracellular potassium loss, intra-/extracellular potassium gradients and digoxin, and the significance of maintaining a normal potassium balance in this setting is stressed.

Topics: Arrhythmias, Cardiac; Creatinine; Digoxin; Diuretics; Electrocardiography; Heart Failure; Humans; Hypokalemia; Middle Aged; Potassium; Potassium Deficiency

Topics: Animals; Arrhythmias, Cardiac; Digoxin; Dogs; Humans; Hypokalemia; Myocardium; Potassium; Potassium Deficiency

Topics: Aged; Arrhythmias, Cardiac; Digitalis Glycosides; Digitoxin; Digoxin; Heart Block; Heart Failure; Heart Valve Diseases; Humans; Middle Aged; Myocardial Infarction; Potassium Deficiency; Strophanthins

Topics: Arrhythmia, Sinus; Arrhythmias, Cardiac; Coronary Disease; Digoxin; Diuretics; Electroconvulsive Therapy; Endocarditis, Bacterial; Heart Aneurysm; Heart Failure; Heart Valve Diseases; Heart Ventricles; Humans; Lidocaine; Myocardial Infarction; Pacemaker, Artificial; Pericarditis, Constrictive; Potassium Deficiency; Rupture; Spironolactone; Tachycardia; Ventricular Fibrillation; Wolff-Parkinson-White Syndrome

Topics: Adult; Digitalis Glycosides; Digitoxin; Digoxin; Diuretics; Dose-Response Relationship, Drug; Female; Heart Failure; Heart Rate; Humans; Lanatosides; Potassium Deficiency; Water-Electrolyte Balance

Topics: Aged; Bendroflumethiazide; Diet; Digoxin; Diuretics; Female; Furosemide; Heart; Heart Failure; Humans; Kidney Tubules; Male; Middle Aged; Posture; Potassium Deficiency

Topics: Animals; Blood Urea Nitrogen; Calcium; Digoxin; Female; Heart; Magnesium Deficiency; Mice; Myocardium; Potassium Deficiency; Time Factors; Tritium

Topics: Adult; Aged; Animals; Cardiomyopathies; Cardiovascular Diseases; Cats; Digoxin; Female; Heart Valve Diseases; Humans; Ischemia; Male; Middle Aged; Potassium Deficiency; Pulmonary Heart Disease

Topics: Acute Kidney Injury; Animals; Digitalis; Digoxin; Hypokalemia; Membrane Potentials; Mice; Myocardium; Plants, Medicinal; Plants, Toxic; Potassium Deficiency; Tritium