[Treatment of life-threatening digoxin poisoning with heterologous digoxin-specific antibody fragments]

Abstract

A 72-year-old woman was admitted to hospital four hours after taking, with suicidal intent, 20 mg digoxin (100 tablets Novodigal) and 50 mg nitrazepam (10 tablets Mogadan). No digoxin tablet residues were found on gastroscopic gastric lavage. A pacemaker was placed transvenously into the apex of the right ventricle. Multifocal ventricular premature systoles and recurrent ventricular fibrillation, which was difficult to terminate, alternating with extreme bradycardia quickly responded to the administration of heterologous digoxin-specific antibodies. Five hours after treatment had been started (total dose 800 mg antibody fragments) the patient again had a stable sinus rhythm of normal rate.