Severe bradycardia at the termination of seizure during electroconvulsive therapy

JA Clinical Reports

Shigeru Saito¹  Takanari Saito¹  Jo Ota¹  Minoru Michizaki¹  Tatsuo Sameshima²  Yuji Kadoi³ 

[1] Department of Anesthesiology, Gunma University School of Medicine, 3-39-15, Showa-machi, Maebashi, Japan;Department of Psychiatry, Minkodo Aburayama Hospital, 5-6-37, Noke, Sawaraku, Fukuoka, Japan;Gunma University Hospital, 3-39-22 Showa-Machi, 371-8511, Maebashi, Gunma, Japan;

关键词: Severe bradycardia;    Electroconvulsive therapy;    Autonomic nerve system;   

DOI  :  10.1186/s40981-020-00389-6

来源: Springer

【 摘 要 】

BackgroundFew cases of asystole or severe bradycardia occurring after the termination of seizure in the third phase with the dominance of parasympathetic nervous system activity during electroconvulsive therapy (ECT) have been reported. We describe a case of severe bradycardia occurring at the termination of seizure.Case presentationThe patient had been diagnosed with bipolar disorder more than 9 years earlier. No adverse hemodynamic events had been observed in over 100 sessions of ECT performed during a 9-year period. ECT was usually induced by propofol and suxamethonium. On this ECT, the heart rate gradually decreased before seizure termination, and severe bradycardia (5–6 beats/min) was identified lasting 15–20 s. Atropine administration immediately before electrical stimulus prevented any further bradycardia during the next session of ECT.ConclusionsThis case report indicates that attention should be paid to adverse cardiac events related to autonomic nerve activity even before such events occur during ECT.

【 授权许可】

CC BY