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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...

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Autores principales: Truedson, Petra, Ott, Michael, Lindmark, Krister, Ström, Malin, Maripuu, Martin, Lundqvist, Robert, Werneke, Ursula
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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