Electrocardiographic and Blood Pressure Alterations During Electroconvulsive Therapy in Young Adults

Rumi, Demétrio Ortega; Solimene, Maria Cecilia; Takada, Julio Yoshio; Grupi, César José; Giorgi, Dante Marcelo Artigas; Rigonatti, Sergio P.; Luz, Protásio Lemos da; Ramires, José Antônio Franchini

doi:10.1590/s0066-782x2002001100007

Cited by 19 publications

(14 citation statements)

References 12 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Only one patient was found to have ST segment depression on baseline ECG, and throughout the ECT cycle. Comparable results were published by Rumi et al [34]; the authors treated 47 patients with ECT and found no significant ST-T changes or cardiac arrhythmias (ST segment depression was present prior the treatment and maintained during ECT in three female patients).…”

Section: Discussionsupporting

confidence: 78%

The impact of electroconvulsive therapy on the spatial QRS-T angle and cardiac troponin T concentration in psychiatric patients

et al. 2019

View full text Add to dashboard Cite

BackgroundElectroconvulsive therapy (ECT) is an effective treatment method used in psychiatry; however, its cardiac safety has not been clearly demonstrated. The aim of the study was evaluation of the ECT effects on the myocardium based on troponin T concentrations and the following ECG parameters: the spatial QRS-T angle (QRS-TA), QRS duration (QRSd) and the corrected QT interval (QTc).MethodsIn the study 44 patients (12 female and 32 male) were enrolled diagnosed with schizophrenia (n = 21) and major depressive disorders (n = 23), according to the DSM-IVR criteria. All cases were undergoing ECT procedures. The mean age of the patients was 36.9±16 years (range: 18–74). Resting ECG was recorded before performing ECG and 1 hour after. The spatial QRS-TA was reconstructed from 12-lead ECG using the inverse Dower method. Troponin T concentration was assessed before the procedure and 6 hours after ECT.ResultsNo significant changes to troponin T concentrations were observed during the ECT series. The pre-ECT value of the spatial QRS-TA was 41.1±18.9°. The follow-up examinations did not reveal any significant increase of this parameter (p = 0.09) in any of the consecutive measurements. There were no significant changes in the QTc interval duration or the QRS complex duration demonstrated before the third, fifth and last procedure in the cycle (p>0.05). No significant changes to troponin T concentrations were observed during the ECT series.ConclusionsOur findings indicate a lack of negative ECT effects on the risk of adverse cardiovascular events measured by the spatial QRS-T angle and cardiac troponin T concentration.

show abstract

Section: Discussionsupporting

confidence: 78%

The impact of electroconvulsive therapy on the spatial QRS-T angle and cardiac troponin T concentration in psychiatric patients

et al. 2019

View full text Add to dashboard Cite

show abstract

“…We observed significant increases in blood pressure during electric shock that returned to basal values after 25 min in the young [4] and after 1 h in the elderly [5]. Significant increases in heart rate were also noted but baseline values were achieved in 25 min only among the young [4]; heart rate remained elevated after 1 h in the elderly [5]. The analysis of heart rate variability showed increased sympathetic activity during ECT [5].…”

mentioning

confidence: 67%

“…The analysis of heart rate variability showed increased sympathetic activity during ECT [5]. No serious adverse effects occurred and ECT did not trigger malignant arrhythmias or ischemia [4,5].…”

mentioning

confidence: 89%

“…We studied 47 young adults [4] and 38 individuals older than 50 years [5] who underwent ECT; ambulatory blood pressure monitoring and continuous electrocardiographic monitoring were performed for 24 h, starting 18 h before and continuing for 3 h after ECT [4,5]. We observed significant increases in blood pressure during electric shock that returned to basal values after 25 min in the young [4] and after 1 h in the elderly [5].…”

mentioning

confidence: 98%

See 1 more Smart Citation

Electroconvulsive therapy and the heart

Solimene

2007

International Journal of Cardiology

View full text Add to dashboard Cite

“…5,7,8 The exaggerated autonomic sympathetic response associated with ECT may also produce an isolated sudden increase of the systolic blood pressure by more than 40% above its baseline. 9 This acute elevation of blood pressure may induce a sudden and transient left ventricular diastolic dysfunction, producing pulmonary edema in the same way as in those cases of hypertension-induced cardiogenic pulmonary edema. 10 It is well documented that ECT increases myocardial oxygen demand, and left ventricular wall motion abnormalities and electrocardiographic changes suggestive of myocardial ischemia have been described.…”

Section: Discussionmentioning

confidence: 99%

Non-Cardiogenic Pulmonary Edema Complicating Electroconvulsive Therapy: Short Review of the Pathophysiology and Diagnostic Approach

Manne¹,

Kasirye²,

Epperla³

et al. 2011

Clinical Medicine & Research

View full text Add to dashboard Cite

Two types of pulmonary edema occur in clinical medicine: cardiogenic pulmonary edema (or hydrostatic pulmonary edema) and noncardiogenic pulmonary edema, better known as acute lung injury or acute respiratory distress syndrome (ARDS). Their clinical manifestations are very similar, so the differentiation between them, based only on clinical grounds, may be very difficult, and knowing the precise etiology of the episode of acute pulmonary edema has major implications in the treatment plan. Cardiogenic pulmonary edema is usually due to systolic and/or diastolic left ventricular dysfunction and is typically treated with diuretics, nitrates, and afterload reduction medications such as angiotensin converting enzyme inhibitors, although some cases also require coronary revascularization. Noncardiogenic pulmonary edema is usually secondary to a more systemic severe medical or surgical pathology that triggers the event, and the treatment should be directed to treat that pathology. Oxygen supplementation in the form of mechanical ventilation (invasive or non-invasive) is always required. A rapid diagnosis of the cause of the episode of acute pulmonary edema facilitates a timely and appropriate therapeutic intervention.Electroconvulsive therapy (ECT) is recognized as a well-established, highlyeffective, safe psychiatric treatment. It is estimated that 100,000 patients per year receive a course of ECT across the United States, with an average of 8 to 10 treatments per course of therapy. Severe complications are very infrequent and generally reported as transitory cardiac arrhythmias and severe transitory Acute pulmonary edema complicating electroconvulsive therapy is an extremely uncommon event that has rarely been described in the literature. Different theories, including one suggesting a cardiogenic component, have been proposed to explain its genesis. The present report describes a classic presentation of this condition with review of its potential mechanisms and diagnostic approach. After successful completion of a session of electroconvulsive therapy, a 42-year-old woman with major depressive disorder developed acute systemic high blood pressure, shortness of breath, and hemoptysis. A chest radiograph demonstrated diffuse bilateral pulmonary infiltrates. Initially cardiogenic pulmonary edema was presumed, but an extensive diagnostic work-up demonstrated normal systolic and diastolic left ventricular function, and with only supportive measures, a complete clinical and radiographic recovery was achieved within 48 hours. The present case does not support any cardiogenic mechanism in the genesis of this condition.

show abstract

Electrocardiographic and Blood Pressure Alterations During Electroconvulsive Therapy in Young Adults

Abstract: Objective -To study cardiovascular alterations in young patients with no apparent organic disease who underwent electroconvulsive therapy. Methods -

Cited by 19 publications

References 12 publications

The impact of electroconvulsive therapy on the spatial QRS-T angle and cardiac troponin T concentration in psychiatric patients

The impact of electroconvulsive therapy on the spatial QRS-T angle and cardiac troponin T concentration in psychiatric patients

Electroconvulsive therapy and the heart

Non-Cardiogenic Pulmonary Edema Complicating Electroconvulsive Therapy: Short Review of the Pathophysiology and Diagnostic Approach

Contact Info

Product

Resources

About