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Abstract
Digoxin causes false-positive ST depression during exercise stress testing, but it
is unknown if digoxin produces ST depression during ambulatory electrocardiographic
monitoring. Fifty healthy volunteers underwent both exercise stress testing and ambulatory
electrocardiographic monitoring before and after 14 days of digoxin (0.25 mg/day)
administration. Significant ST depression was defined as ≥1 mm of horizontal or downsloping
ST depression 80 ms after the J point lasting for ≥60 seconds.
During therapy, 13 subjects (26%) had at least 1 episode of ST depression and 5 subjects
(10%) had multiple episodes of ST depression detected by ambulatory monitoring. Ten
subjects (20%) had ST depression that occurred during exercise that was detected by
both stress test and ambulatory monitoring. Three subjects (6%) had ST depression
that was detected on the ambulatory recording only at times other than during the
stress test. Stratification of demographic and clinical variables did not predict
digoxin-induced ST depression.
Thus, digoxin causes false-positive ST depression detected by ambulatory monitoring.
The incidence is similar to that observed during stress testing, but also occurs at
heart rates lower than that achieved during stress tests. Ambulatory electrocardiographic
monitoring will be less useful in the noninvasive assessment of coronary artery disease
in patients receiving digoxin.
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Article info
Publication history
Accepted:
July 24,
1991
Received in revised form:
July 23,
1991
Received:
June 6,
1991
Identification
Copyright
© 1991 Published by Elsevier Inc.
