Yoko Suzuki1, Miho Miyajima1, Katsuya Ohta1,2,3, Noriko Yoshida1,4, Rie Omoya1,5, Mayo Fujiwara1,3, Takafumi Watanabe1,6, Masaki Okumura7, Hiroaki Yamazaki8, Masayuki Shintaku6, Issei Murata6, Shigeru Ozaki6, Takeshi Sasaki6, Mitsuru Nakamura4, Hiroshi Suwa9, Tetsuo Sasano2, Tokuhiro Kawara10, Masato Matsuura11, Eisuke Matsushima1. 1. Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. 2. Department of Biofunctional Informatics, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan. 3. Onda-daini Hospital, Chiba, Japan. 4. Narimasu Kosei Hospital, Tokyo, Japan. 5. Wako Hospital, Saitama, Japan. 6. Tokyo Metropolitan Health and Medical Corporation Toshima Hospital, Tokyo, Japan. 7. Oishi Memorial Hospital, Tokyo, Japan. 8. Yowa Hospital, Tokyo, Japan. 9. Tokyo Kyosai Hospital, Tokyo, Japan. 10. Graduate School of Health Care Science, Bunkyo Gakuin University, Tokyo, Japan. 11. Tokyo Medical and Dental University, Tokyo, Japan.
Abstract
BACKGROUND: Electrocardiogram abnormalities have been reported during electroconvulsive therapy (ECT). A corrected QT interval (QTc) prolongation indicates delayed ventricular repolarization, which can trigger ventricular arrhythmias such as torsade de pointes (TdP). We examined the QTc changes during generalized tonic-clonic seizures induced by ECT, and the effects of atropine sulfate on these QTc changes. METHODS: We analyzed heart rate, QT interval, and QTc in 32 patients with depression who underwent ECT (25 women, 67.4 ± 8.7 years of age). The QTc from -30 to 0 seconds prestimulation was used as baseline, which was compared with QTc at 20-30 seconds and 140-150 seconds poststimulus onset. RESULTS: QTc was significantly prolonged at 20-30 seconds poststimulus, then significantly decreased at 140-150 seconds poststimulus, compared with baseline. QTc prolongation induced by ECT was significantly decreased by atropine sulfate. CONCLUSIONS: These data suggest that the risk of TdP may be enhanced by ECT. Further, the risk of cardiac ventricular arrhythmias, including TdP, may be reduced by administration of atropine sulfate.
BACKGROUND: Electrocardiogram abnormalities have been reported during electroconvulsive therapy (ECT). A corrected QT interval (QTc) prolongation indicates delayed ventricular repolarization, which can trigger ventricular arrhythmias such as torsade de pointes (TdP). We examined the QTc changes during generalized tonic-clonic seizures induced by ECT, and the effects of atropine sulfate on these QTc changes. METHODS: We analyzed heart rate, QT interval, and QTc in 32 patients with depression who underwent ECT (25 women, 67.4 ± 8.7 years of age). The QTc from -30 to 0 seconds prestimulation was used as baseline, which was compared with QTc at 20-30 seconds and 140-150 seconds poststimulus onset. RESULTS:QTc was significantly prolonged at 20-30 seconds poststimulus, then significantly decreased at 140-150 seconds poststimulus, compared with baseline. QTc prolongation induced by ECT was significantly decreased by atropine sulfate. CONCLUSIONS: These data suggest that the risk of TdP may be enhanced by ECT. Further, the risk of cardiac ventricular arrhythmias, including TdP, may be reduced by administration of atropine sulfate.