2-1-102. Changes in corrected QT interval during electroconvulsive therapy

Publication date: June 2017
Source:Clinical Neurophysiology, Volume 128, Issue 6
Author(s): Yoko Suzuki, Miho Miyajima, Katsuya Ohta, Noriko Yoshida, Mayo Fujiwara, Masaki Okumura, Mitsuru Nakamura, Tetsuo Sasano, Tokuhiro Kawara, Masato Matsuura, Eisuke Matsushima
Corrected QT interval (QTc) prolongation can trigger ventricular arrhythmia, including torsade de pointes (TdP). A QTc greater than 500ms is considered to provide a high risk of TdP. Herein, we evaluated the risk of TdP during electroconvulsive therapy (ECT) using QTc. Twenty-two patients who underwent ECT were included. QTc were calculated with Hodges formula to avoid overcorrection of heart rate in a total of 201 ECT sessions. Baseline QTc was averaged over 30 s before stimulus onset. A QTc >457ms was classified as a significant prolongation, and >500ms as marked prolongation. The number of significant and marked QTc prolongations at baseline and the post-stimulus period were counted. At baseline, significant QTc prolongation was observed in 15 of 201 ECTs, while no patients showed marked prolongation. For post-stimulation, significant QTc prolongation and marked QTc prolongation was observed in 109 and 5 out of 201 ECT sessions, respectively. All the five marked QTc prolongations during post-ECT stimulation followed significant baseline QTc prolongation. These data suggest that a prolonged pre-stimulus QTc may be a risk factor of post-stimulus TdP in ECT.



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