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The electrophysiologic effects of digoxin. A. Digoxin effect. Please note the scooped ST-segment depressions (arrows). B. Atrial fibrillation with a slow ventricular response. Note the scooped ST segments (arrows) and ventricular premature contractions (VPC) (star). C. Atrial fibrillation with a junctional bradycardia. D. Bidirectional ventricular tachycardia. Note the wide QRS duration and undulating QRS axis (arrows). Reproduced with permission from Kummer JL, Nair R, Krishnan SC. Images in cardiovascular medicine. Bidirectional ventricular tachycardia caused by digitalis toxicity. Circulation. 2006;113:e156-e157. Source: Chapter 95. Adverse Cardiovascular Drug Interactions and Complications, Hurst's The Heart, 13e Citation: Fuster V, Walsh RA, Harrington RA. Hurst's The Heart, 13e; 2011 Available at: http://mhmedical.com/ Accessed: May 11, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved