Swartz Conrad M, Shen Winston W
Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL 62794-9642, USA.
J ECT. 2007 Jun;23(2):71-4. doi: 10.1097/YCT.0b013e3180314681.
Heart rate (HR) accelerates with the electroconvulsive therapy (ECT) seizure and decelerates when it ends. The peak HR during ECT seizure has been reported to reflect clinical impact. We aimed to identify the expected range for ECT peak HR and how it varies with age and sex, as a reference in clinical use.
We examined medical records for the maximum peak seizure HR over the ECT course for all ECT patients over defined periods at 2 clinical sites. Methohexital-succinylcholine anesthesia was usually used. Subject totals were 87 men and 90 women.
Electroconvulsive therapy peak HR was 140 to 180 bpm and did not fall with age through 80 years, separately for men and women. A few patients lay outside this cluster and showed age-related decrease. Overall and including the extreme elderly, peak HR fell by 0.29 bpm/yr.
Electroconvulsive therapy seizure peak HR less than 140 bpm points to weakness of the ECT seizure (and need to increase stimulus dose), cardiac disease, or medication effect limiting HR. Electroconvulsive therapy peak HR exceeds treadmill exercise maximum HR after 60 years and falls significantly less with age than the 0.7 to 1 bpm/yr reported for maximum HR with treadmill exercise stress. These comparisons suggest that ECT peak HR and treadmill maximum HR are limited by different aspects of physiology, and that exercise HR is limited by metabolic demand and humoral activity rather than the heart itself.
心率（HR）在电休克治疗（ECT）发作时加速，结束时减速。据报道，ECT发作期间的最高心率可反映临床影响。我们旨在确定ECT最高心率的预期范围及其随年龄和性别的变化情况，作为临床应用的参考。
我们检查了两个临床地点在规定时间段内所有ECT患者ECT疗程中癫痫发作时最高心率的病历。通常使用甲己炔巴比妥-琥珀酰胆碱麻醉。受试者总数为87名男性和90名女性。
ECT最高心率为140至180次/分钟，男性和女性在80岁之前均未随年龄下降。少数患者不在此范围内，且显示出与年龄相关的下降。总体而言，包括高龄患者在内，最高心率每年下降0.29次/分钟。
ECT癫痫发作最高心率低于140次/分钟表明ECT癫痫发作较弱（需要增加刺激剂量）、患有心脏病或药物作用限制了心率。ECT最高心率在60岁后超过跑步机运动的最高心率，且随年龄下降的幅度明显小于跑步机运动应激时最高心率每年下降0.7至1次/分钟的报道。这些比较表明，ECT最高心率和跑步机最高心率受生理不同方面的限制，运动心率受代谢需求和体液活动而非心脏本身的限制。
