lithium use in atrial fibrillation

[michaelrack]

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There's a lot of literature regarding EKG changes with lithium, and lithium being a potential cause of a fib.

Has anyone here ever started lithium in someone with chronic afib (who had never been on lithium before)? I wasn't able to find any literature on this doing a quick pub med search. Would a fib be considered an absolute contraindication to the initiation of lithium?

 

[Taddy Mason]

This is news to me. I just checked K&S, Clinical Manual of Psychopharm in the Medically Ill, Managing the Side Effects of Psychotropic Meds, and Maudsley and all I came across was that per Maudsley, Li, VPA, and CBZ appear not to affect the risk of AF. Maudsley only cites one case of AF following Li overdose and once case in chronic toxicity. Bradycardia/heart block are really the only cardiac concerns I’m aware of.

 

[michaelrack]

This is news to me. I just checked K&S, Clinical Manual of Psychopharm in the Medically Ill, Managing the Side Effects of Psychotropic Meds, and Maudsley and all I came across was that per Maudsley, Li, VPA, and CBZ appear not to affect the risk of AF. Maudsley only sites one case of AF following Li overdose and once case in chronic toxicity. Bradycardia/heart block are really the only cardiac concerns I’m aware of.

thank you. I looked at pub med again, and I guess most of the reports of afib with lithium use were at toxic levels.

I was able to find this short article, which seems to agree with what you are saying: Lithium: Cardiac Adverse Effects and When to Get an ECG

 

[Sushirolls]

I'd be more concerned an afib patient had their OSA treated, which I know you are more keen than most to treat.