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Updated: Dec 7, 2025
Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Implantable Cardioverter-Defibrillator Shock Delivered During Electroconvulsive Therapy Despite Magnet Application: A
Scott C Streckenbach1, William J Benedetto, Michael G Fitzsimons
1From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract:
Electroconvulsive therapy (ECT) in a patient with an implantable cardioverter-defibrillator (ICD) presents challenges to anesthesiologists. We encountered a patient who received an inappropriate shock during ECT despite magnet application. The phenomenon provides insight into how ICDs work-how they can inappropriately detect ECT stimulation and how they deliver antitachycardia therapy. We illuminate issues related to using magnets, discuss risks associated with inappropriate ICD therapy, and provide guidance for ICD management during ECT.
