Do you routinely check digoxin levels, and if so, when would you consider using Digibind in chronic digoxin use patients?   

The subanalysis of the DIG trial gave some insight into the value of keeping digoxin levels below 1.0. If HF patients, I tend to look at the levels for that reason.  I rarely use digoxin for AF as there is little evidence of benefit with some evidence of harm.  Re: use of digibind, I lim...

I rarely use digoxin as well. I think it can be helpful in patients with HF and Afib who are not able to tolerate a beta blocker and do not have other options.

Digoxin levels correlate with maximum inotropic effects for CHF indication. Control of AFib is based on the toxic blocking effects of digoxin, and levels are not predictive and may, in fact, need to be much higher than "therapeutic." Digoxin toxicity is based on symptoms and not levels; therefore, D...