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Clinicians should not use digoxin in ventricular pre-excitation syndromes such as Wolff-Parkinson-White (WPW), as it may shorten the refractory period of the accessory pathway, trigger rapid ventricular conduction, and cause hemodynamic collapse or sudden cardiac death (56)(58)

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The LactMed database reports minimal transfer into breast milk, and it has decades of safety data in lactating women