Effects of Electroconvulsive Therapy on Cardiac Function in Patients without Heart Disease

Abstract

In order to determine whether electroconvulsive therapy (ECT) alters left-ventricular function in patients without heart disease, we studied 11 patients who had a normal cardiovascular system and were submitted to ECT. Left-ventricular function was assessed by means of a clinical examination and an echocardiographic evaluation performed before the ECT and 20 min and 6 h after ECT. Twenty minutes after ECT, the patients’ end-systolic volume was increased (p = 0.003), whereas the ejection fraction (p = 0.004) and E to A ratio were decreased (p = 0.004 and 0.028, respectively). These indexes returned to the normal control value 6 h later. None of our patients presented any clinical signs of heart failure. We conclude that in some patients, ECT produces a significant and transient decrease in left-ventricular systolic and diastolic function.

Safety of Electroconvulsive Therapy in Patients With a History of Heart Failure and Decreased Left Ventricular Systolic Heart Function

“…Metoprolol (10) Labetalol (1) Glycopyrrolate (10) None Lisinopril (10) Succinylcholine (10) Digoxin (10) Thiopental (10) 10 Lisinopril (12) Labetalol (7) Glycopyrrolate (12) None Furosemide (12) Succinylcholine (12) Digoxin (12) Thiopental (12) (7) Digoxin (7) 14 Lisinopril (7) Esmolol (1) Succinylcholine (7) None Furosemide (7) Thiopental (4) Etomidate (3) (1) Thiopental (17) Etomidate (4) 16 Metoprolol (8) None Glycopyrrolate (7) None Lisinopril (8) Succinylcholine (7) Digoxin (8) Thiopental (7) 17 Losartan (17) Esmolol (2) Glycopyrrolate (17) PVCs (6) Furosemide (17) Lidocaine (15) Succinylcholine (17) Digoxin (17) Thiopental (17) 18 Lisinopril ( Lisinopril (6) Esmolol (2) Glycopyrrolate (6) None Furosemide (6) Succinylcholine (6) Etomidate (6) 21 Lisinopril (5) Labetalol (1) Glycopyrrolate (5) None Succinylcholine (5) Thiopental (5) 22 Metoprolol (7) None Glycopyrrolate (6) None Succinylcholine (7) Thiopental (7) 23 Metoprolol ( …”

“…It is widely available, rapid, noninvasive, and safe, and it provides extensive information about cardiac anatomy, wall motion, and valve function. 5,6 Hence, ECT in patients with systolic heart failure may lead to cardiovascular morbidity and death. Patients who have diastolic heart failure have symptoms or signs of heart failure and a left ventricular ejection fraction greater than 40% to 50%.…”

Electroconvulsive therapy in the medically Ill

“…Consultation with a cardiologist would be needed in addition to the standard pre-ECT work-up and determine what further investigative studies may be required, such as stress testing or echocardiograms before initiating ECT. Consideration may be given to the knowledge that left ventricular ejection fraction in patients receiving ECT often shows a temporary, transient decrease in systolic and diastolic dysfunction [20,21].…”

Impact and Clinical Management of Depression in Patients with Coronary Artery Disease

“…In addition, electroconvulsive therapy can lead to elevations in blood pressure and heart rate, transient arrhythmias, and decreases in LVEF in healthy subjects. [80][81][82] The Identifying Depression as a Comorbid Condition (IDACC) trial was a large randomized study that did not examine the impact of medical or psychologic therapy, but rather a patientspecific case management approach to caring for depressed patients with cardiac disease. 74,83 Hospitalized patients with cardiac disease (72% had acute coronary syndrome) and depression as identified by the Center for Epidemiologic Studies-Depression (CES-D) survey were randomly assigned to intervention (331 patients) or usual care (338 patients).…”