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Neurological and renal adverse effects of lithium are well recognised, but cardiac complications such as symptomatic bradycardia and varying degrees of heart block are under-recognised, yet they are potentially life-threatening manifestations of lithium toxicity, even at therapeutic or mildly elevated levels. These conduction abnormalities may present insidiously and can be easily overlooked, particularly in elderly patients or those with underlying cardiac disease. Early recognition is critical, as prompt discontinuation of lithium typically leads to rapid clinical and electrocardiographic improvement, often obviating the need for pacing. This highlights the importance of maintaining a high index of suspicion, routine cardiovascular assessment and individualised risk\u2013benefit evaluation in patients receiving lithium therapy to prevent serious morbidity and mortality.<\/jats:p>","DOI":"10.1177\/00258172261439612","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:59:32Z","timestamp":1778741972000},"page":"185-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bradycardia and heart block due to lithium toxicity"],"prefix":"10.1177","volume":"94","author":[{"given":"Rupert Nithin","family":"Fernando Edwin","sequence":"first","affiliation":[{"name":"Glan Clwyd Hospital, Rhyl, Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2498-584X","authenticated-orcid":false,"given":"Bhagya Sree","family":"Velamala","sequence":"additional","affiliation":[{"name":"Glan Clwyd Hospital, Rhyl, Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Pierce","sequence":"additional","affiliation":[{"name":"Holywell Community Hospital, Holywell, Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Harman","sequence":"additional","affiliation":[{"name":"Holywell Community Hospital, Holywell, Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedamurthy","family":"Adhiyaman","sequence":"additional","affiliation":[{"name":"Glan Clwyd Hospital, Rhyl, Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/ph18081230"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-023-00310-x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3727\/096368909X471251"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-016-0068-y"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-015-0040-2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61516-X"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2007.08.058"},{"issue":"3","key":"e_1_3_2_9_2","article-title":"Lithium-induced cardiotoxicity: a rare clinical entity","volume":"12","author":"Acharya S","year":"2020","unstructured":"Acharya S, Siddiqui AH, Anwar S, et al. 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