Electrocardiographic and blood pressure alterations during electroconvulsive therapy in young adults.
OBJECTIVE
To study cardiovascular alterations in young patients with no apparent organic disease who underwent electroconvulsive therapy.


METHODS
The study comprised 47 healthy patients (22 males and 25 females) with a mean age of 30.3 years, who underwent electroconvulsive therapy. Ambulatory blood pressure monitoring and continuous electrocardiographic monitoring (Holter monitor) were performed during 24 hours. Blood pressure and heart rate were assessed 4 hours prior to electric shock administration, during electric shock administration, and 3 hours after electric shock administration. Arrhythmias and alterations in the ST segment in 24 hours were recorded.


RESULTS
On electroconvulsive therapy, a significant increase in blood pressure and heart rate was observed and the measurements returned to basal values after 25 minutes. Three females had tracings with depression of the ST segment suggesting myocardial ischemia prior to and after electroconvulsive therapy. Coronary angiography was normal. No severe cardiac arrhythmias were diagnosed.


CONCLUSIONS
1) Electroconvulsive therapy is a safe therapeutic modality in psychiatry; 2) it causes a significant increase in blood pressure and heart rate; 3) it may be associated with myocardial ischemia in the absence of coronary obstructive disease; 4) electroconvulsive therapy was not associated with the occurrence of severe cardiac arrhythmias.
Rumi
Demetrio Ortega
DO
Instituto de Psiquiatria do Hospital das Clinicas da FMUSP, Sao Paulo, Brazil.
Solimene
Maria Cecília
MC
Takada
Júlio Yoshio
JY
Grupi
César José
CJ
Giorgi
Dante Marcelo
DM
Rigonatti
Sérgio Paulo
SP
Luz
Protásio Lemos da
PL
Ramires
José Antonio Franchini
JA
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology