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Comparative Study
. 1993 Jun;150(6):904-9.
doi: 10.1176/ajp.150.6.904.

Cardiovascular complications of ECT in depressed patients with cardiac disease

R J Zielinski  1 , S P Roose, D P Devanand, S Woodring, H A Sackeim
Affiliations
Comparative Study

Cardiovascular complications of ECT in depressed patients with cardiac disease

R J Zielinski et al. Am J Psychiatry. 1993 Jun.

Abstract

Objective: This study was conducted to determine the safety of electroconvulsive therapy (ECT) for depressed patients with serious cardiac disease.

Method: The rate of complications in 40 patients with major depressive disorder and left ventricular impairment, ventricular arrhythmias, and/or conduction delay who received ECT was compared to the rate of complications in a matched comparison group of 40 depressed patients without cardiac disease who also received ECT. In addition, 21 of the patients with cardiac illness had received one or more inpatient trials of tricyclic antidepressants before receiving ECT, thereby permitting a comparison of cardiovascular complications of medication and ECT in the same patients.

Results: The patients with cardiac disease had a significantly higher rate of cardiac complications during ECT than did the comparison group without cardiac disease. The type of preexisting cardiac abnormality strongly predicted the type of cardiac complication that occurred during ECT. However, most of the complications were transitory and did not prevent the completion of ECT. Of the 21 patients with cardiac disease who had received tricyclic trials before ECT, 11 had been forced to discontinue drug treatment because of substantial cardiovascular side effects. In comparison, 38 of the 40 cardiac patients completed the course of ECT.

Conclusions: With close monitoring for the development of arrhythmia and ischemic episodes, ECT can be given with relative safety to patients with severe cardiovascular disease.

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Comment in

  • Cardiovascular complications of ECT.
    Kellner CH, Beale MD. Kellner CH, et al. Am J Psychiatry. 1994 May;151(5):789-90; author reply 791. doi: 10.1176/ajp.151.5.aj1515789. Am J Psychiatry. 1994. PMID: 8166340 No abstract available.
  • Cardiovascular complications of ECT.
    Stoudemire A. Stoudemire A. Am J Psychiatry. 1994 May;151(5):790; author reply 791. Am J Psychiatry. 1994. PMID: 8166341 No abstract available.
  • Cardiovascular complications of ECT.
    Figiel GS, McDonald L, LaPlante R. Figiel GS, et al. Am J Psychiatry. 1994 May;151(5):790-1. Am J Psychiatry. 1994. PMID: 8166342 No abstract available.

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