IF there is A. fib + CHF ==> Give Dig... it slows ventricular response rate in a fib by slowing down AV conduction and thus increasing fillint. It also has a + Inotropic effect so helps the systolic dysfunction...
Howeve in another question it says:
Dig causes ATRIAL TACHYCARDIA w/ AV Block at therapeutic levels!!!
so my question is --wouldn't Atrial Tachycardia be bad for A.fib when we give Dig?
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dr.wad Forum Senior
Topics: 3 Posts: 350
01/09/08 - 09:38 AM
#2
even if atrial tachy occurs , u already blocked the conduction to the ventricles.
the goal here is to slow the ventricular rate.
mildus Forum Guru
Topics: 19 Posts: 614
01/09/08 - 01:24 PM
#3
I think digoxin leads to bradycardia not tachycardia (decreases conduction in atria and AV node), but can provoke ventricular tachyarrythmias in toxic levels. Digoxin does not increase oxygen consumption since it doesn't lead to tachycardia (vs. adrenaline) (major factors increasing O2 consumsion in heart are wall stress and tachycardia)
arlete Forum Fanatic
Topics: 50 Posts: 3,581
01/09/08 - 01:45 PM
#4
A patient that is in atrial fibrillation can't have atrial tachycardia at the same time. Atrial tachycardia means a single atrial foci stimulating the atrios, it's the only pacemaker working, at a fast rate. Atrial fibrillation means you have multiple points sending electrical impulses at the same time, each one taking over a variable area of the atrio (therefore making it refractory to a new impulse), and these impulses are transmitted to the ventricles in a variable, irregular fashion (determined mostly by the AV node conduction). So you won't have a single impulse taking over the atrial rhythm, going against so many different points. (I am not sure I expressed myself clearly, please, let me know), even during digital toxicity.
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DrVirgo Forum Hero
Topics: 1096 Posts: 3,515
01/09/08 - 02:02 PM
#5
dr.wad wrote: even if atrial tachy occurs , u already blocked the conduction to the ventricles.
the goal here is to slow the ventricular rate.
Ok that makes sense.
thanks everyone.
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