Lithium-Associated Mobitz II Block: Case Series and Review of the Literature


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Address for reprints: Ehrin J. Armstrong, M.D., Department of Medicine, Division of Cardiology, University of California, 505 Parnassus Avenue, Box 0124, San Francisco, CA 94143-0124. Fax: 415-233-4724; e-mail:


We report two cases of lithium-associated Mobitz II block. Both patients required placement of a permanent pacemaker due to persistent block and symptoms despite attempts at lowering the daily dose of lithium. We then reviewed the literature on this rare complication. Chronic lithium therapy may be associated with development of conduction block at or below the level of the atrioventricular node. Patients taking lithium should be monitored closely for development of cardiovascular complications. (PACE 2011; 34:e47–e51)