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Mania and Antimanic Drugs: Overview01:24

Mania and Antimanic Drugs: Overview

Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as a...
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...

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Related Experiment Video

Updated: May 16, 2026

Laser-Induced Action Potential-Like Measurements of Cardiomyocytes on Microelectrode Arrays for Increased Predictivity of Safety Pharmacology
10:41

Laser-Induced Action Potential-Like Measurements of Cardiomyocytes on Microelectrode Arrays for Increased Predictivity of Safety Pharmacology

Published on: September 13, 2022

[Complete atrioventricular block during lithium therapy within therapeutic range].

A Halboos1, F Jockenhövel

  • 1Evangelisches Krankenhaus Herne, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen. a.halboos@evk-herne.de

Deutsche Medizinische Wochenschrift (1946)
|November 29, 2012
PubMed
Summary

Chronic lithium therapy can cause complete atrioventricular block, a rare but serious cardiac complication. This condition requires prompt pacemaker implantation for symptom resolution and improved prognosis.

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Area of Science:

  • Cardiology
  • Psychiatry
  • Pharmacology

Background:

  • Bipolar disorder management often involves long-term lithium treatment.
  • Lithium is known for potential cardiac side effects, though severe conduction abnormalities are uncommon.

Observation:

  • A 69-year-old male with bipolar disorder presented with vertigo and presyncope.
  • Clinical examination revealed bradycardia (36 bpm); electrocardiography confirmed complete atrioventricular block.
  • Laboratory tests, including lithium levels (0.7 mmol/l), were within therapeutic ranges.

Findings:

  • Complete atrioventricular block was diagnosed, potentially secondary to chronic lithium therapy.
  • Pacemaker implantation successfully resolved symptoms and stabilized heart rate.

Implications:

  • This case highlights the rare but significant risk of complete atrioventricular block associated with lithium, even at therapeutic levels.
  • Early recognition and intervention, such as pacemaker implantation, are crucial for managing this adverse effect.
  • Clinicians should maintain a high index of suspicion for cardiac complications in patients on long-term lithium treatment.