Question:hard
Which is not seen in digoxin toxicity?
Which is not seen in digoxin toxicity?
Show Hint
Digoxin slows AV node and the ventricular rate but does not convert AF to a regular rhythm.
Updated On: Jun 24, 2026
- Bidirectional ventricular tachycardia
- Paroxysmal atrial tachycardia
- Ventricular bigeminy
- Regularisation of atrial fibrillation
Show Solution
The Correct Option is D
Solution and Explanation
The toxic ECG signatures of digoxin arise from a paradoxical pairing of speeded-up ectopic pacemakers and slowed-down AV conduction. Because intracellular calcium rises, automaticity surges, giving the dramatic bidirectional ventricular tachycardia, frequent ventricular ectopics arranged as ventricular bigeminy, and atrial tachyarrhythmias such as paroxysmal atrial tachycardia, the last often accompanied by AV block. All three of those are genuine toxic findings. The fourth choice, regularisation of atrial fibrillation, does not fit the picture: digoxin in a fibrillating patient simply blunts AV transmission and lowers the ventricular rate but leaves the chaotic atrial activity intact, so it neither restores sinus rhythm nor smooths the irregular rhythm into a regular one. A regular rhythm emerging in AF would point to complete AV block with an escape pacemaker, not to plain regularisation. Therefore the feature that is not a recognised marker of digoxin toxicity is regularisation of atrial fibrillation. \[\boxed{\text{Regularisation of atrial fibrillation}}\]
Was this answer helpful?
0
