Digoxin is a cardiac glycoside medication used for systolic heart failure and arrhythmias such as atrial fibrillation. Digoxin toxicity can cause ECG changes and arrhythmias.

•Digoxin Effects on the ECG:

•Diffuse ST segment scooping and depression.

•QT shortening.

•Flattening of the T wave or biphasic T wave.

•U waves.


Atrioventricular (AV) blocks (1st, 2nd or 3rd degree).

•Regular junctional rhythm in the setting of atrial fibrillation (3rd degree AV block with a junctional escape rhythm).

•Almost any arrhythmia.