Name of the Procedure:

Injection, Digoxin, up to 0.5 mg (HCPCS Code J1160)

Common name: Digoxin Injection

Summary

Digoxin injection is a medical procedure used to administer the cardiac glycoside digoxin directly into the bloodstream. This medication helps improve heart efficiency and regulate heart rate, especially in patients with certain heart conditions.

Purpose

Digoxin injections address heart-related issues such as atrial fibrillation and heart failure. The primary goals are to improve heart contractility, reduce symptoms like fatigue and shortness of breath, and stabilize heart rhythm.

Indications

• Atrial fibrillation (irregular heartbeat)
• Heart failure
• Patients with symptomatic heart issues who do not respond to oral medications
• Patients needing rapid onset of action due to acute symptoms

Preparation

• Fasting is typically not required.
• Disclose all current medications and health conditions to the physician.
• Blood tests may be necessary to check kidney function and electrolyte levels.
• Regular monitoring of heart rate and blood pressure before the procedure.

Procedure Description

1. The patient will be seated or lying down.
2. An intravenous (IV) line is established to administer the medication.
3. The injection site is cleaned with antiseptic.
4. Digoxin, up to 0.5 mg, is slowly injected into the IV line.
5. The healthcare provider monitors the heart rate, blood pressure, and any immediate reactions.

Tools/Equipment: IV line, antiseptic wipes, syringe containing digoxin.

Anesthesia: Not required; the procedure includes potentially mild discomfort.

Duration

The injection itself takes a few minutes, but monitoring might extend the visit to around 30-60 minutes.

Setting

This procedure is typically performed in a hospital, outpatient clinic, or a physician’s office.

Personnel

• Physician or nurse practitioner
• Registered nurse (RN)
• Medical assistant (optional)

Risks and Complications

• Common risks: Mild pain or discomfort at the injection site, nausea, dizziness.
• Rare risks: Allergic reactions, digoxin toxicity, irregular heart rhythms (arrhythmias).

Benefits

• Improved heart function and efficiency.
• Reduced symptoms of heart failure and atrial fibrillation.
• Rapid onset of action compared to oral medications.
• Symptom relief may be noticed within a few hours to days.

Recovery

• Patients can usually resume normal activities shortly after the procedure.
• Observe the injection site for any signs of infection or reactions.
• Follow-up appointments may be necessary to monitor the effectiveness and adjust dosages.
• Regular blood tests to check digoxin levels and kidney function.

Alternatives

• Oral digoxin: Slower onset of action but convenient for long-term treatment.
• Other medications: Beta-blockers, calcium channel blockers, or other antiarrhythmic drugs.
• Pros and cons: Oral medications avoid injection discomfort but take longer to act. Alternative drugs may have different side effect profiles.

Patient Experience

During the procedure, the patient may feel a slight pinch at the injection site and some mild discomfort as the medication is administered. Post-procedure, patients might experience fatigue or dizziness, which usually resolves quickly. Pain management is typically unnecessary due to the minimal discomfort involved. Comfort measures include resting and monitoring by healthcare providers.