{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:30:35Z","timestamp":1790836235387,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2005,9,13]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            The characteristic ECG pattern of ST-segment elevation in V\n            <jats:sub>1<\/jats:sub>\n            and V\n            <jats:sub>2<\/jats:sub>\n            in the Brugada syndrome is dynamic; it is often intermittently present in affected individuals and can be unmasked by sodium channel blockers, including antiarrhythmic drugs and tricyclic antidepressants. We report here 2 patients who developed the Brugada ECG pattern after administration of lithium, a commonly used drug not previously reported to block cardiac sodium channels.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Lithium induced transient ST-segment elevation (type 1 Brugada pattern) in right precordial leads at therapeutic concentrations in 2 patients with bipolar disorder. Lithium withdrawal in the patients resulted in reversion to type 2 or 3 Brugada patterns or resolution of ST-T abnormalities. In Chinese hamster ovary cells transfected with\n            <jats:italic>SCN5A<\/jats:italic>\n            , which encodes the cardiac sodium channel, lithium chloride caused concentration-dependent block of peak\n            <jats:italic>I<\/jats:italic>\n            <jats:sub>Na<\/jats:sub>\n            at levels well below the therapeutic range (IC\n            <jats:sub>50<\/jats:sub>\n            of 6.8\u00b10.4 \u03bcmol\/L).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            The widely used drug lithium is a potent blocker of cardiac sodium channels and may unmask patients with the Brugada syndrome.\n          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Vanderbilt University School of Medicine, Nashville, Tenn, and Cardiology Department (A.A.M.W.), Academic Medical Center, Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Churchwell","sequence":"additional","affiliation":[{"name":"From the Divisions of Clinical Pharmacology (D.D., T.Y., D.M.R.) and Cardiovascular Medicine (D.D., K.C., D.M.R.), Vanderbilt University School of Medicine, Nashville, Tenn, and Cardiology Department (A.A.M.W.), Academic Medical Center, Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur A.M.","family":"Wilde","sequence":"additional","affiliation":[{"name":"From the Divisions of Clinical Pharmacology (D.D., T.Y., D.M.R.) and Cardiovascular Medicine (D.D., K.C., D.M.R.), Vanderbilt University School of Medicine, Nashville, Tenn, and Cardiology Department (A.A.M.W.), Academic Medical Center, Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan M.","family":"Roden","sequence":"additional","affiliation":[{"name":"From the Divisions of Clinical Pharmacology (D.D., T.Y., D.M.R.) and Cardiovascular Medicine (D.D., K.C., D.M.R.), Vanderbilt University School of Medicine, Nashville, Tenn, and Cardiology Department (A.A.M.W.), Academic Medical Center, Amsterdam, the 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