ECG Strip 14
An elderly patient was hospitalized because of general deterioration including dehydration and bradycardia. She regularly uses digoxin and the serum level of digoxin is above 3ng/ml, which is clearly a toxic value. In ECG there is RBBB and severe sinus bradycardia. The number of large squares in the ECG paper between 2 neighboring QRS complexes is approximately seven and that corresponds with heart rate circa 27 beats per minute (300:7). The patient was treated with atropine and aminophyllin, the digoxin usage has been discontinued. The condition quickly improved to a sinus rhythm with heart rate 60 per minute.