Cardiac effects of electroconvulsive therapy - a systematic review

Area of Science:

• Cardiology
• Psychiatry
• Neuroscience

Background:

• Electroconvulsive therapy (ECT) can induce cardiovascular stress, prompting re-evaluation of its cardiac safety.
• Understanding the short- and long-term cardiac effects of ECT is crucial for patient management.

Approach:

• A systematic literature search of PubMed and Web of Science identified 196 relevant studies and case reports.
• Results were categorized based on general cardiac effects, cardiovascular complications (including electrical, structural, and vascular issues), and management strategies.

Key Points:

• Serious cardiac complications from ECT are infrequent in individuals with healthy hearts.
• Risk mitigation strategies are recommended for patients with pre-existing cardiac conditions.
• There are no absolute cardiac contraindications for undergoing ECT.

Conclusions:

• Baseline troponin measurements may be beneficial for patients with cardiac risk factors.
• Arrhythmias and troponin elevations do not necessarily indicate a poor prognosis.
• Long-term cardiac benefits of ECT may include attenuation of sympathetic activation and hormonal imbalances.