Brugada-Type Electrocardiographic Changes Induced by Long-Term Lithium Use
Bibliographic record
Abstract
A 49-year-old man presented to the emergency depart- ment with a 3-month history of increasing ataxia, tremors, and slurred speech.He had a history of bipolar disorder that required lithium, carbamazepine, and risperidone therapy for mood modulation.A serum lithium level measurement was performed and was found to be 2.5 mmol/L (therapeutic range 0.8 to 1.2 mmol/L).There was no history of suicidal ideation, recent medication changes, improper medication administration, recent volume depletion, or renal insufficiency.There was no family history consistent with sudden cardiac death.A 12-lead ECG showed normal sinus rhythm at a rate of 64 bpm, with a normal axis, a prolonged corrected QT interval of 479 ms, and a pseudo right bundle-branch block pattern consistent with a type 1 Brugada pattern (Figure 1).The patient was managed conservatively with discontinuation of the lithium, intravenous hydration, and serial lithium level measurements and ECGs.The ECGs showed gradual resolu-Figure 1. Twelve-lead ECG showing Brugada type 1 pattern with corresponding lithium level of 2.7 mmol/L.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".