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Oral theophylline corrects sinus node dysfunction in acute on chronic lithium toxicity: case report and systematic
J Curran Henson1, Lauren Morehead2, Joshua Hagood1
1Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
Frontiers in Cardiovascular Medicine
|September 13, 2024
Summary
Theophylline effectively treated sinus node dysfunction caused by lithium toxicity, offering a less invasive alternative to pacing or dialysis. This study highlights a novel approach for managing cardiac complications of lithium overdose.
Area of Science:
- Cardiology
- Pharmacology
- Toxicology
Background:
- Lithium toxicity can cause serious cardiac issues, including sinus node dysfunction (SND), which is often underreported.
- Current management for lithium-induced SND may involve invasive procedures like temporary or permanent pacing.
Observation:
- A case report details the successful use of theophylline, a positive chronotropic agent, to correct lithium-induced SND.
- A systematic literature review identified 49 unique studies on lithium-induced SND, noting bradycardia and sinus arrest as common EKG findings.
Findings:
- Theophylline provided effective rate and rhythm correction for SND in a patient with acute lithium toxicity.
- The review found that while many patients recovered, some required interventions such as vasopressors, temporary pacing, or permanent pacemaker implantation.
Implications:
- Theophylline represents a potentially preferable, less invasive treatment option for lithium-induced SND compared to hemodialysis or pacing.
- This approach may help avoid invasive procedures and improve patient outcomes in cases of lithium toxicity.
Keywords:
arrythmiahemodialysislithiumlithium toxicitysick sinus syndromesinus bradycardiasinus node dysfunctiontemporary pacingMore Related Videos
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