Evaluation of ventricular repolarization features with Tp-e, Tp-e/QTc, JTc and JTd during electroconvulsive therapy

The purpose of this study was to investigate the influence of electrical stimulation transmitted through the body during electroconvulsive therapy on traditional and relatively new ventricular repolarization parameters (Rate corrected QT interval (QTc), QT dispersion (QTd), rate corrected JT interval (JTc), JT dispersion (JTd), T-peak to T-end interval (Tp-e) and Tp-e/QTc ratio) under propofol anaesthesia.

Twenty-two patients (aged 18-50 years) who were each scheduled for ECT for major depression, bipolar disorder or schizophrenia enrolled to the study. Electrocardiography (ECG) recordings were obtained before anaesthesia and within 3-5 min after electrical stimulus of ECT for measurements. QTc, QTd, JTc, JTd, Tp-e and Tp-e/QTc were measured as repolarization indices.

The study included twenty-two patients, 9(40.9%) females and 13(59.1%) males, and the mean age accounted for 33.57 ± 9.95 years. The comparison of the measured parameters before and after ECT, which were not statistically different, were as follows: QTc (416.52 ± 46.64 vs 430.00 ± 34.00msn; p = 0.18), JTc (308.09 ± 25.09 vs 315.47 ± 26.89msn; p = 0.30), QTd (22.27 ± 11.51 vs 20.45 ± 9.9msn; p = 0.52) and JTd (22.72 ± 11.2 vs 17.72 ± 10.20msn; p = 0.06). Also, no significant difference was detected at the following parameters Tp-e (80.0 ± 13.45 vs 78.63 ± 15.21msn; p = 0.65) and Tp-e/QTc ratio (0.19 ± 0.03 vs 0.18 ± 0.07; p = 0.08). On the other hand, HR showed a significant increase after ECT at 88.13 ± 13.74 vs 93.0 ± 15.2 bpm; p = 0.03.

QTc, QTd, JTc, JTd, Tp-e interval and Tp-e/QTc ratio, which are thought to be potential repolarisation markers for ventricular arrhythmias, did not demonstrate significant change within 3-5 min of electrical stimulation during ECT.