Recognizing Digitalis Toxicity in Patients With Artificial Pacemakers

Abstract

In a patient with ventricular rhythm induced by an artificial cardiac pacemaker, the clue to diagnosis of digitalis intoxication lies in electrocardiographic recognition of altered atrial mechanism, particularly the appearance of retrograde P waves. Recognition of ventricular premature contractions is also very important. Illustrative cases of all the arrhythmias detected in 20 pacemaker patients with digitalis toxicity are presented.