Key result
Combined propafenone and lithium induces Brugada-like ST elevation in WPW via synergistic sodium channel blockade.
Why the study?
The electrocardiographic effects of concomitant use of lithium and propafenone in patients with Wolff-Parkinson-White syndrome were not well characterized.
Concomitant use of lithium and propafenone can induce Brugada-type ECG changes, likely due to synergistic sodium channel blocking effects.
May warrant ECG monitoring with propafenone-lithium co-use; leaves open systematic evaluation of interaction risk.
We report a case of ST elevation in right precordial leads compatible with type 1 Brugada syndrome following administration of propafenone in a patient with Wolff-Parkinson-White syndrome who was receiving lithium at concentrations within therapeutic levels. The mechanism of the electrocardiogram changes was considered to be caused by the two drugs synergistic sodium channel blocking effects.
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Fragakis et al. (2007) studied this question. Concomitant use of propafenone and lithium induced type 1 Brugada-like ST elevation in a patient with Wolff-Parkinson-White syndrome due to synergistic sodium channel blocking effects.
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