title: Resuming electroconvulsive therapy (ECT) after emergence of asymptomatic atrial fibrillation during a course of right unilateral ECT.
abstract: Atrial fibrillation induced by electroconvulsive therapy (ECT) is rare, with only 3 reported cases. None of those cases involved either young healthy patients or right unilateral ECT. We report a 46-year-old healthy male observed to be in atrial fibrillation immediately after electrical induction of the 25th administration of right unilateral ECT. Diltiazem was administered, and he spontaneously cardioverted. After a negative cardiology workup, he safely resumed ECT. Atrial fibrillation was most likely triggered by autonomic imbalance due to the combination of electrical induction, seizure, and medication.
authors.forename: George
authors.initials: G
authors.lastname: Loeffler
authors.forename: Marc
authors.initials: M
authors.lastname: Capobianco
mesh_terms: D000758:Anesthesia; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004110:Diltiazem / Q000627:therapeutic use; D004562:Electrocardiography; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D004569:Electroencephalography; D007839:Functional Laterality / Q000502:physiology; D006024:Glycopyrrolate / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000523:psychology; D059020:Suicidal Ideation; D013617:Tachycardia, Supraventricular / Q000209:etiology
chemical_list: D002317:Cardiovascular Agents; D018727:Muscarinic Antagonists; D004110:Diltiazem; D006024:Glycopyrrolate