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Bidirectional ventricular tachycardia as a complication of uncontrolled digoxin intake: case report

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Abstract

DOI: 10.32364/2587-6821-2024-8-7-2

D.V. Peterburgsky^1,2, E.A. Sinitsyn^1,3^, E.V. Smolyakova¹, K.A. Zykov^1,3

¹Russian University of Medicine, Moscow, Russian Federation
²A.S. Puchkov Ambulance and Emergency Medical Care Station, Moscow, Russian Federation ³Research Institute of Pulmonology of the Russian Federal Medical Biological Agency, Moscow, Russian Federation

Cardiac glycosides (CG) are one of the first drug groups that have been used in the treatment of cardiac diseases for more than 200 years. Despite this, their use is still a matter of dispute and constant discussion within the medical community. It is known that CG increases the myocardial contractility, slows down conduction in the atrioventricular node, which helps delaying the heart rate and improves systemic hemodynamics in atrial fibrillation (AF) during heart failure. Despite this, CG has not been a first-line drug for a long time. Among CGs, digoxin is used as the most studied drug in many clinical studies. Taking digoxin is commonly associated with the development of adverse events such as bradycardia, ventricular extrasystole, nausea, vomiting. One of the most dangerous side effects of CG is considered to be a pro-arrhythmogenic effect, in particular, their ability to provoke ventricular tachycardia. The authors present a case study of rare bidirectional ventricular tachycardia in a 78-year-old female patient with a persistent AF during long-term uncontrolled digoxin intake. Analyzing this case, the authors conclude that more careful follow-up of long-term digoxin intake is necessary to exclude the development of its side effects.

Keywords: case study, bidirectional ventricular tachycardia, atrial fibrillation, cardiac glycosides, digitalis toxicity.

For citation: Peterburgsky D.V., Sinitsyn E.A., Smolyakova E.V., Zykov K.A. Bidirectional ventricular tachycardia as a complication of uncontrolled digoxin intake: case report. Russian Medical Inquiry. 2024;8(7):386–390 (in Russ.). DOI: 10.32364/2587-6821-2024-8-7-2.

ABOUT THE AUTHORS:

Dmitry V. Peterburgsky — Clinical Resident of the Department of Faculty Therapy and Occupational Diseases of the Medical Faculty of the N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; general practitioner of the Emergency Medical Team for Adult Population, A.S. Puchkov Ambulance and Emergency Medical Care Station; 3, build. 3, Koptelskiy Lane, Moscow, 129090, Russian Federation; ORCID iD 0009-0005-8364-9239.

Evgeny A. Sinitsyn — C. Sc. (Med.), Assistant Professor of the Department of Faculty Therapy and Occupational Diseases of the Medical Faculty of the N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; Senior Researcher at the Laboratory of Clinical Pulmonology, Research Institute of Pulmonology of the Russian Federal Medical Biological Agency, Moscow; 28, Orekhovy Avenue, Moscow, 115682, Russian Federation; ORCID iD 0000-0002-8813-5932.

Ekaterina V. Smolyakova — C. Sc. (Med.), Assistant Professor of the Department of Faculty Therapy and Occupational Diseases of the Medical Faculty of the N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0002-1904-5319.

Kirill A. Zykov — Dr. Sc. (Med.), Professor of the RAS, Corresponding Member of the RAS, Head of the Department of Faculty Therapy and Occupational Diseases of the Medical Faculty of the N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; Deputy Director for Scientific and Innovative Work, Research Institute of Pulmonology of the Russian Federal Medical Biological Agency, Moscow; 28, Orekhovy Avenue, Moscow, 115682, Russian Federation; ORCID iD 0000-0003-3385-2632.

Contact information: Dmitry V. Peterburgsky, e-mail: kasper.piter@yandex.ru.

Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.

There is no conflict of interest.

Received 13.05.2024.

Revised 05.06.2024.

Accepted 01.07.2024.

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