Hase Koukichi, Yoshioka Hitoshi, Nakamura Takako, Kamei Toshirou, Isse Kunihiro, Nakamura Mitsuru
Department of Anesthesia Tokyo Metropolitan Toshima Hospital, Tokyo 173-0015.
Masui. 2005 Nov;54(11):1268-72.
Asystole during electroconvulsive therapy (ECT) has been reported as an uncommon but fatal complication. But cardiac movement during electrical stimulation has not been well known.
The cardiac movements during electrical stimulation of fifty psychiatric patients treated by ECT under general anesthesia were observed utilizing thoracic echocardiography. Observations of 117 times were performed. Rate pressure products (RPP) immediately before stimulation and during 10 minutes after stimulation were calculated. Asystole was defined as absence of heartbeat for over 2 seconds.
Asystoles were observed 57 times (48.7%). The heartbeat recovered immediately after stimulation in all asystole cases. RPP increased just after stimulation in all cases. Asystole cases had significantly greater variation of RPP than cases without aystole. (P = 0.0082).
Electrical stimulation by ECT activates parasympathetic nervous system and convulsion by the stimulation activates sympathetic nervous system. As asystole case had good reactive automatic nervous system, asystole might have been provoked by the stimulation with a greater increase in RPP after the stimulation.
电休克治疗（ECT）期间的心搏停止已被报道为一种罕见但致命的并发症。但电刺激期间的心脏活动尚未为人熟知。
利用胸部超声心动图观察了50例在全身麻醉下接受ECT治疗的精神科患者在电刺激期间的心脏活动。共进行了117次观察。计算刺激前及刺激后10分钟内的心率血压乘积（RPP）。心搏停止定义为心跳停止超过2秒。
观察到心搏停止57次（48.7%）。所有心搏停止病例在刺激后心跳立即恢复。所有病例在刺激后RPP立即升高。心搏停止病例的RPP变化显著大于无心搏停止病例。（P = 0.0082）。
ECT的电刺激激活副交感神经系统，刺激引起的惊厥激活交感神经系统。由于心搏停止病例具有良好的自主神经系统反应性，心搏停止可能是由刺激诱发的，刺激后RPP升高幅度更大。
