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Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study
(1) Background: Few studies have explored the impact of lithium intoxication on the heart. (2) Methods: We examined electrocardiogram (ECG) changes associated with lithium intoxication in the framework of the LiSIE (Lithium—Study into Effects and Side Effects) retrospective cohort study. We analysed...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572509/ https://www.ncbi.nlm.nih.gov/pubmed/36233807 http://dx.doi.org/10.3390/jcm11195941 |
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author | Truedson, Petra Ott, Michael Lindmark, Krister Ström, Malin Maripuu, Martin Lundqvist, Robert Werneke, Ursula |
author_facet | Truedson, Petra Ott, Michael Lindmark, Krister Ström, Malin Maripuu, Martin Lundqvist, Robert Werneke, Ursula |
author_sort | Truedson, Petra |
collection | PubMed |
description | (1) Background: Few studies have explored the impact of lithium intoxication on the heart. (2) Methods: We examined electrocardiogram (ECG) changes associated with lithium intoxication in the framework of the LiSIE (Lithium—Study into Effects and Side Effects) retrospective cohort study. We analysed ECGs before, during, and after intoxication. (3) Results: Of the 1136 patients included, 92 patients had experienced 112 episodes of lithium intoxication. For 55 episodes, there was an ECG available at the time; for 48 episodes, there was a reference ECG available before and/or after the lithium intoxication. Lithium intoxication led to a statistically significant decrease in heart rate from a mean 76 beats/min (SD 16.6) before intoxication to 73 beats/min (SD 17.1) during intoxication (p = 0.046). QTc correlated only weakly with lithium concentration (ρ = 0.329, p = 0.014). However, in 24% of lithium intoxication episodes, there were QT prolongations. In 54% of these, QTc exceeded 500 ms; patients with chronic intoxications being more affected. (4) Conclusions: Based on summary statistics, effects of lithium intoxication on HR and QTc seem mostly discrete and not clinically relevant. However, QT prolongation can carry a risk of becoming severe. Therefore, an ECG should always be taken in patients presenting with lithium intoxication. |
format | Online Article Text |
id | pubmed-9572509 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95725092022-10-17 Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study Truedson, Petra Ott, Michael Lindmark, Krister Ström, Malin Maripuu, Martin Lundqvist, Robert Werneke, Ursula J Clin Med Article (1) Background: Few studies have explored the impact of lithium intoxication on the heart. (2) Methods: We examined electrocardiogram (ECG) changes associated with lithium intoxication in the framework of the LiSIE (Lithium—Study into Effects and Side Effects) retrospective cohort study. We analysed ECGs before, during, and after intoxication. (3) Results: Of the 1136 patients included, 92 patients had experienced 112 episodes of lithium intoxication. For 55 episodes, there was an ECG available at the time; for 48 episodes, there was a reference ECG available before and/or after the lithium intoxication. Lithium intoxication led to a statistically significant decrease in heart rate from a mean 76 beats/min (SD 16.6) before intoxication to 73 beats/min (SD 17.1) during intoxication (p = 0.046). QTc correlated only weakly with lithium concentration (ρ = 0.329, p = 0.014). However, in 24% of lithium intoxication episodes, there were QT prolongations. In 54% of these, QTc exceeded 500 ms; patients with chronic intoxications being more affected. (4) Conclusions: Based on summary statistics, effects of lithium intoxication on HR and QTc seem mostly discrete and not clinically relevant. However, QT prolongation can carry a risk of becoming severe. Therefore, an ECG should always be taken in patients presenting with lithium intoxication. MDPI 2022-10-08 /pmc/articles/PMC9572509/ /pubmed/36233807 http://dx.doi.org/10.3390/jcm11195941 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Truedson, Petra Ott, Michael Lindmark, Krister Ström, Malin Maripuu, Martin Lundqvist, Robert Werneke, Ursula Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study |
title | Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study |
title_full | Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study |
title_fullStr | Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study |
title_full_unstemmed | Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study |
title_short | Effects of Toxic Lithium Levels on ECG—Findings from the LiSIE Retrospective Cohort Study |
title_sort | effects of toxic lithium levels on ecg—findings from the lisie retrospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572509/ https://www.ncbi.nlm.nih.gov/pubmed/36233807 http://dx.doi.org/10.3390/jcm11195941 |
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