Almost any type of cardiac arrhythmia is seen in digitalis toxicity. However, type II second-degree atrioventricular (AV) block is not seen. The arrhythmias commonly seen are sinus bradycardia, first-degree AV block, ventricular extra systoles (uniform and multiform), and ventricular bigeminy. Wenckebach type of block may be seen.
Complete heart block, sino-atrial (SA) block, AV dissociation, AV junctional rhythm, and ventricular fibrillation may be observed sometimes. Non-paroxysmal atrial tachycardia with variable AV block is characteristic of digitalis toxicity. The various ECG changes in digitalis toxicity are summarized in Box 9.1.
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