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The effects of a single intravenous dose (1.5 mg) of diogoxin on the resting and exercise ECG were studied over several days in twelve normal subjects. Maximal ST-segment and T-wave changes were observed 24 h after drug administration. A significant ST-segment depression and decrease in T-wave amplicude were still observed on the 7th and 11th day after the glycoside dose, in spite of undetectable digoxin plasma concentrations. There was no correlation between digoxin plasma concentration and ECG-changes. In order to avoid false positive ischaemic ST-segment responses to exercise, a therapy with digoxin should be discontinued for at least 2 weeks before the exercise test.
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