Endpoint of ECT-induced elevation in heart rate.

Area of Science:

• Cardiology
• Neurology
• Psychiatry

Background:

• Heart rate (HR) changes during electroconvulsive therapy (ECT) can reflect deeper brain seizure activity than electroencephalography (EEG) or motoric measures.
• Evaluating HR response during ECT may offer insights into treatment quality.

Purpose of the Study:

• To investigate the relationship between baseline heart rate and the pattern of heart rate elevation endpoint during electroconvulsive therapy (ECT).
• To determine if baseline heart rate can predict specific heart rate responses during ECT.

Main Methods:

• A prospective study analyzed electrocardiographic (ECG) records from 24 patients undergoing ECT.
• The abruptness of the endpoint of seizure-induced heart rate elevation was assessed.
• Patients were categorized based on whether their HR endpoint was abrupt or gradual.

Main Results:

• Of 24 patients, 19 exhibited abrupt HR endpoints, while 5 showed gradual endpoints.
• Patients with abrupt endpoints had significantly lower baseline HR (88 ± 10 bpm) compared to those with gradual endpoints (118 ± 12 bpm; p < 0.00001).
• A baseline HR threshold of 100 bpm differentiated between abrupt (below) and gradual (above) endpoints.

Conclusions:

• Baseline heart rate is a significant predictor of the heart rate response pattern during ECT.
• Patients with low baseline heart rates may be at higher risk for bradyarrhythmia during ECT.
• Consideration of precautions for patients with low baseline heart rates is recommended during ECT procedures.