title: Atrial Fibrillation, Cardioversion, and Electroconvulsive Therapy.
abstract: An elderly female patient with major depression and incidental atrial fibrillation received electroconvulsive therapy (ECT). Minutes after two different treatments on two separate occasions, she converted to a normal sinus rhythm. Although atrial fibrillation itself is associated with an increased risk of thromboembolic stroke, cardioversion without anticoagulation in individuals with nonacute atrial fibrillation is associated with a 1-2% incidence of embolization. Cardioversion during ECT may be infrequent but its possibility should alert clinicians to the consideration of prophylactic anticoagulation for some patients undergoing ECT.
authors.affiliation: Department of Psychiatry, Medical College of Wisconsin and Medical Psychiatry Unit, Milwaukee County Medical Complex, Milwaukee, Wisconsin, USA.
authors.forename: Harold H.
authors.initials: HH
authors.lastname: Harsch