Asystole during electroconvulsive therapy: a case report
1Department of Psychiatry, The Chinese Univeersity of Hong Kong, Prince of Wales Hospital, Shatin, NT. tangwk@cuhk.edu.hk
The Australian and New Zealand Journal of Psychiatry
|July 5, 2001
Summary
A patient experienced an 18-second asystole during electroconvulsive therapy (ECT) without prior heart issues. Atropine premedication and adjusted ECT protocols prevented recurrence, allowing continued treatment.
Area of Science:
- Cardiology
- Neurology
- Psychiatry
Background:
- Electroconvulsive therapy (ECT) is a treatment for severe depression.
- Cardiovascular complications, though rare, can occur during ECT.
Observation:
- A 65-year-old male patient without cardiovascular history developed an 18-second asystole after a subconvulsive stimulus during ECT.
- The asystole was followed by transient bradycardia, which resolved spontaneously.
Findings:
- Asystole did not recur in subsequent ECT sessions after intravenous atropine premedication and use of suprathreshold stimuli.
- The patient had a history of depression and had previously responded well to ECT.
Implications:
- Asystole during ECT does not necessarily require treatment suspension.
- Atropine premedication and modified ECT parameters can mitigate the risk of asystole.
- Careful patient selection and monitoring are crucial for safe ECT administration.
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