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

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[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

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.