Automatic implantable cardioverter defibrillator in electroconvulsive therapy.
Ethan O Bryson1, Dennis M Popeo, Mimi C Briggs
1From the Departments of *Anesthesiology, and †Psychiatry, Mount Sinai School of Medicine, New York, NY.
The Journal of ECT
|August 23, 2014
Summary
The risk of inappropriate discharge from automatic implantable cardioverter defibrillators during electroconvulsive therapy is low. Keeping the device active offers significant benefits for treating dangerous heart rhythms.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Increasing prevalence of patients with implantable cardiac devices undergoing electroconvulsive therapy (ECT).
- Concerns regarding potential inappropriate discharge from automatic implantable cardioverter defibrillators (ICDs) due to ECT-induced artifacts.
Observation:
- Artifacts generated during ECT may be misinterpreted by ICDs as treatable arrhythmias.
- Deactivation of ICDs before ECT has been a common practice due to this concern.
Findings:
- The risk of an inappropriate ICD discharge during ECT is considered very low.
- The benefits of maintaining an active ICD outweigh the minimal risk of inappropriate discharge.
Implications:
- Patients with ICDs may not require deactivation before undergoing ECT.
- Maintaining active ICD function ensures prompt treatment of life-threatening cardiac dysrhythmias during or after ECT.
- This approach prioritizes patient safety by ensuring continuous cardiac monitoring and therapeutic intervention.
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