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Atrial Fibrillation, Cardioversion, and Electroconvulsive Therapy.
1Department of Psychiatry, Medical College of Wisconsin and Medical Psychiatry Unit, Milwaukee County Medical Complex, Milwaukee, Wisconsin, USA.
Convulsive Therapy
|January 1, 1991
Summary
Electroconvulsive therapy (ECT) may spontaneously convert atrial fibrillation to normal sinus rhythm. This finding suggests considering prophylactic anticoagulation for patients undergoing ECT, especially those with atrial fibrillation, to mitigate stroke risks.
Area of Science:
- Cardiology
- Neurology
- Psychiatry
Background:
- Atrial fibrillation (AF) increases stroke risk.
- Electroconvulsive therapy (ECT) is used for major depression.
- Cardioversion without anticoagulation in non-acute AF carries a 1-2% embolization risk.
Purpose of the Study:
- To report a case of spontaneous cardioversion from atrial fibrillation to normal sinus rhythm following electroconvulsive therapy.
- To highlight the potential cardiac implications of ECT in patients with pre-existing arrhythmias.
Main Methods:
- Case report of an elderly female patient with major depression and incidental atrial fibrillation.
- Observation of cardiac rhythm changes after electroconvulsive therapy (ECT) treatments.
Main Results:
- The patient spontaneously converted from atrial fibrillation to normal sinus rhythm minutes after two separate ECT sessions.
- This observed cardioversion occurred without any specific cardiac intervention during ECT.
Conclusions:
- ECT may induce spontaneous cardioversion in patients with atrial fibrillation.
- Clinicians should consider prophylactic anticoagulation for patients undergoing ECT who have atrial fibrillation to prevent potential thromboembolic events.
- This case underscores the importance of cardiac monitoring during and after ECT in at-risk populations.