Electroconvulsive Therapy in the Medically Compromised Patient

Abrams, Richard

doi:10.1016/s0193-953x(18)30273-9

Cited by 13 publications

(4 citation statements)

References 66 publications

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“…Periods of sinus asystole (cardiac standstill longer than 5 seconds) can occur if bradycardia and hypotension are not prevented. 10 Anticholinergic agents (ie, atropine and glycopyrrolate) block the parasympathetic vagal outflow, thereby preventing bradycardia, hypotension, and increased salivation. Atropine remains the most frequently used drug for vagal blockade.…”

Section: Discussionmentioning

confidence: 99%

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Use of Electroconvulsive Therapy in a Patient 10 Days After Myocardial Infarction

Magid¹,

Lapid²,

Sampson³

et al. 2005

The Journal of ECT

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Electroconvulsive therapy (ECT) is a safe and effective treatment of severe depression, even in patients with cardiac risk factors. Although rare, cardiovascular events during ECT remain a principal cause of morbidity and mortality. In particular, a history of recent myocardial infarction (MI) increases the risk of ventricular arrhythmias and cardiac rupture. A widely accepted recommendation is to administer ECT at least 3 months after MI, but sometimes a delay is not possible. Limited literature exists on the use of ECT in severely depressed patients with recent MI. Our literature review revealed 1 previously published case, with less than favorable results. In this case report, we describe a severely depressed, catatonic elderly man who was safely and successfully treated with ECT 10 days after an acute MI. It is essential that appropriate cardiac management be provided before, during, and after ECT by a multidisciplinary team of psychiatrists, internists, cardiologists, and anesthesiologists. Our case report suggests that, with proper management and close monitoring, ECT can be administered safely, even in patients with recent MI.

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Section: Discussionmentioning

confidence: 99%

“…12 Arrhythmias that frequently occur during the recovery phase of ECT can be attenuated by both beta-blockers and lidocaine. 10 In recent years, lidocaine is used less frequently because of its many adverse effects. With our patient, labetalol, 5 to 30 mg IV, was administered after half his ECT courses.…”

Section: Discussionmentioning

confidence: 99%

Use of Electroconvulsive Therapy in a Patient 10 Days After Myocardial Infarction

Magid¹,

Lapid²,

Sampson³

et al. 2005

The Journal of ECT

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“…

Cardiac dysrhythmias are frequent complications of electroconvulsive therapy (ECT) [1,2]. In the majority of cases, they are transient and benign, and rarely lead to the termination of ECT, even in elderly patients with pre-existing cardiovascular morbidity.Asystole, a potentially lethal complication, is defined as a period of electrical silence on electrocardiogram (ECG) lasting at least 10 s [3].

…”

mentioning

confidence: 99%

“…Cardiac dysrhythmias are frequent complications of electroconvulsive therapy (ECT) [1, 2]. In the majority of cases, they are transient and benign, and rarely lead to the termination of ECT, even in elderly patients with pre-existing cardiovascular morbidity.…”

mentioning

confidence: 99%

Asystole During Electroconvulsive Therapy: A Case Report

Tang

Ungvari

2001

Aust N Z J Psychiatry

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When proper precautions are taken, asystole does not necessitate the suspension of further ECT sessions but intravenous atropine should be considered as premedication in such cases. Inducing anaesthesia with methohexital, avoiding excessive amounts of succinylcholine and employing suprathreshold stimulus and unilateral electrode placement may further lessen the likelihood of asystole in susceptible cases.

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Características del estímulo en terapia electroconvulsiva. Una revisión pragmática

Sanz-Fuentenebro

2018

Revista de Psiquiatría y Salud Mental

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Electroconvulsive Therapy in the Medically Compromised Patient

Cited by 13 publications

References 66 publications

Use of Electroconvulsive Therapy in a Patient 10 Days After Myocardial Infarction

Use of Electroconvulsive Therapy in a Patient 10 Days After Myocardial Infarction

Asystole During Electroconvulsive Therapy: A Case Report

Características del estímulo en terapia electroconvulsiva. Una revisión pragmática

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