What is the first-line treatment for digoxin toxicity with heart block?

Digoxin toxicity can lead to significant cardiovascular effects, including heart block, which is often a serious complication. The first-line treatment for this condition is the administration of digoxin-specific antibody fragments, also known as Digibind or Digifab. These antibodies bind to digoxin in the bloodstream, effectively neutralizing its effects and facilitating its excretion from the body. This mechanism directly addresses the underlying toxicity, allowing for the correction of related issues such as heart block.

In contrast, treatment options like isoprenaline may only provide symptomatic relief by increasing heart rate and may not effectively resolve the toxicity itself. Vasopressors are used to support blood pressure in instances of shock but are not specific for managing digoxin toxicity. Calcium chloride could potentially be used in certain types of cardiac arrhythmias but does not address the root cause of digoxin-related heart block. Therefore, administering digoxin-specific antibody fragments is the most appropriate and effective strategy for managing this critical condition.