ECT generalized seizure drives heart rate above treadmill stress test maximum

Area of Science:

• Cardiology
• Neurology
• Psychiatry

Background:

• Heart rate (HR) increases during electroconvulsive therapy (ECT) seizures and decreases afterward.
• Peak HR during ECT is linked to seizure impact.
• Understanding typical ECT HR ranges is crucial for clinical interpretation.

Purpose of the Study:

• To establish the expected range for peak HR during ECT seizures.
• To investigate how peak HR during ECT varies with patient age and sex.
• To provide a clinical reference for ECT-induced HR responses.

Main Methods:

• Retrospective analysis of peak seizure HR from medical records of ECT patients.
• Inclusion of data from two clinical sites.
• Data collected from 87 men and 90 women, typically under methohexital-succinylcholine anesthesia.

Main Results:

• The typical peak HR during ECT seizures was 140 to 180 bpm.
• Peak HR did not decline with age up to 80 years in most men and women.
• A slight overall age-related decrease of 0.29 bpm/year was observed, particularly in the very elderly.

Conclusions:

• ECT peak HR below 140 bpm may suggest seizure inadequacy, cardiac disease, or medication effects.
• Peak ECT HR surpasses maximum treadmill exercise HR after age 60.
• Physiological limitations differ between ECT and exercise HR, with exercise HR influenced by metabolic demand.