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Placement of Stimulus Electrodes and Heart Rate during Electroconvulsive Therapy.

Summary of "Placement of Stimulus Electrodes and Heart Rate during Electroconvulsive Therapy."


OBJECTIVE:
Bifrontal stimulation in electroconvulsive therapy (ECT) has been increasingly administered and evaluated over the past years. However, no attention has been paid to cardiac side effects of this novel form of treatment during the application of the electrical stimuli.
METHOD:
Cardiac responses to different electrode positions were compared intraindividually, using synchronised electrocardiograms and waveforms of pulse oximetry.
RESULTS:
Unilateral ECT gave rise to a marked cardiac response during stimulation. Intervals between two consecutive heartbeats increased from 0.6 ± 0.0 sec to 4.1 ± 3.4 sec (mean ± standard deviation). In contrast, stable heart actions were documented in the same patients during bifrontal stimulation.
CONCLUSION:
The placement of the stimulus electrodes for ECT determines the incidence of asystole events during stimulation. Bifrontal electrode positioning results in less activation of the vagus nerve than unilateral treatment. The longer distance from the electrode site to the nerve in bifrontal treatment could account for these findings.

Affiliation

Klinikum Schloß Winnenden (Ärztlicher Direktor Dr. G. Hetzel).

Journal Details

This article was published in the following journal.

Name: Fortschritte der Neurologie-Psychiatrie
ISSN: 1439-3522
Pages:

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Medical and Biotech [MESH] Definitions

A complex involuntary response to an unexpected strong stimulus. The reaction involves physical movement away from the stimulus, MUSCLE CONTRACTION and limb flexion, BLINKING, and changes in HEART RATE, BLOOD PRESSURE, and RESPIRATION.

Therapy for MOVEMENT DISORDERS, especially PARKINSON DISEASE, that applies electricity via stereotactic implantation of ELECTRODES in specific areas of the BRAIN such as the THALAMUS. The electrodes are attached to a neurostimulator placed subcutaneously.

The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.

Methods, techniques, and processes by which HEART RATE is measured.

Electrically induced CONVULSIONS primarily used in the treatment of severe AFFECTIVE DISORDERS and SCHIZOPHRENIA.

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