Electroconvulsive therapy in patients with cardiac pacemakers
R D MacPherson1, C K Loo, N Barrett
1Department of Anaesthesia and Pain Management, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Anaesthesia and Intensive Care
|August 18, 2006
Summary
Electroconvulsive therapy (ECT) is safe for elderly patients with cardiac pacemakers. A review of 147 treatments showed only one complication, suggesting routine ECG monitoring is sufficient.
Area of Science:
- Cardiology
- Neurology
- Anesthesiology
Background:
- Electroconvulsive therapy (ECT) is generally well-tolerated with few contraindications.
- Elderly patients with cardiac pacemakers may theoretically face increased risks during ECT.
Purpose of the Study:
- To assess the safety and complications of anesthesia and ECT in elderly patients with cardiac pacemakers.
- To determine if specific precautions are necessary for this patient group.
Main Methods:
- Retrospective audit of patients receiving anesthesia for ECT between January 1999 and September 2005.
- Analysis of anesthetic procedures in ten patients with cardiac pacemakers in situ.
- Review of a total of 147 ECT treatments.
Main Results:
- 147 ECT treatments were administered to ten patients with cardiac pacemakers.
- Anesthesia proceeded uneventfully in 146 out of 147 treatments.
- No significant increase in complications was observed, even with rate-responsive pacemakers.
Conclusions:
- Anesthesia and ECT are safe for patients with cardiac pacemakers, including rate-responsive types.
- Routine ECG monitoring is adequate; no extraordinary precautions are typically required.
- This study supports the continued use of ECT in elderly patients with pacemakers.
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