title: Asystole in ultrabrief pulse electroconvulsive therapy.
abstract: OBJECTIVE
  Ultrabrief (UB) pulse electroconvulsive therapy (ECT) has been gaining popularity in recent years because of its improved cognitive adverse effect profile compared with treatments triggered by brief pulses. When delivered at maximal charge, UB pulses are administered for 8 seconds. Because electrical stimulation triggers a parasympathetic surge and transient asystole, we checked whether UB pulses delivered for 8 seconds were associated with prolonged cardiac pause compared with maximal charge delivered for 4 seconds with brief pulses.
  
  
  METHODS
  This is a retrospective study of cardiac pause length of all patients undergoing ECT treatment at The Johns Hopkins Hospital during 1 year.
  
  
  RESULTS
  Electrocardiac pause length for patients undergoing ECT with right unilateral placement at maximal charge was not affected by pulse width. However, we did find cardiac pause length to be sensitive to 2- versus 4-second duration stimuli using brief pulses (P < 0.0001).
  
  
  CONCLUSIONS
  Notwithstanding the clear limitations of small sample size and retrospective design, we found that right unilateral ECT was not affected by pulse width when maximal charge was delivered.
authors.affiliation: The Johns Hopkins University School of Medicine, Baltimore, MD, USA. jcoughl2@jhmi.edu
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Coughlin
authors.forename: Kyle
authors.initials: K
authors.lastname: Rodenbach
authors.forename: Pin-Hsuan
authors.initials: PH
authors.lastname: Lee
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Hayat
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Griffin
authors.forename: Marek A
authors.initials: MA
authors.lastname: Mirski
authors.forename: Irving M
authors.initials: IM
authors.lastname: Reti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D004566:Electrodes; D005260:Female; D006321:Heart / Q000502:physiology / Q000503:physiopathology; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult