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Diffuse T-wave inversions associated with electroconvulsive therapy.

Kevin E O'Brien1, Nicholas Pastis, Jamie B Conti

  • 1Division of General Internal Medicine, University of Florida Health Science Center, Tampa, Florida, USA. kobrien@hsc.usf.edu

The American Journal of Cardiology
|June 15, 2004
PubMed
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Electroconvulsive therapy (ECT) can cause heart rhythm changes, including T-wave inversions, especially in patients with pre-existing heart conditions. These changes may be linked to increased sympathetic nervous system activity during ECT.

Area of Science:

  • Cardiology
  • Neurology
  • Psychiatry

Background:

  • Electroconvulsive therapy (ECT) is a medical treatment most often used for patients with severe major depression or other psychiatric disorders who have not responded to other treatments.
  • Patients with coronary artery disease undergoing ECT may experience myocardial oxygen supply-demand mismatch, leading to ST depression and arrhythmias.

Observation:

  • This report details a case of global T-wave inversions during ECT in a patient with chronic atrial fibrillation on digoxin.
  • The patient's laboratory evaluations and echocardiography results were within normal limits.

Findings:

  • ECT-associated global T-wave inversions were observed.
  • These cardiac changes are hypothesized to result from heightened sympathetic nervous system activity during ECT.

Related Experiment Videos

  • Prospective studies indicate that such findings may occur in approximately 4% of patients undergoing ECT.
  • Implications:

    • Clinicians should be aware of potential ECT-induced cardiac repolarization abnormalities, particularly in patients with underlying cardiovascular disease.
    • Monitoring for T-wave changes during and after ECT may be warranted in susceptible patient populations.
    • Further research is needed to elucidate the precise mechanisms and clinical significance of ECT-associated T-wave inversions.