Fedai Ülker Atılan, Fedai Halil
Harran University Faculty of Medicine, Department of Psychiatry, Şanlıurfa, Turkey.
Harran University Faculty of Medicine, Department of Cardiology, Şanlıurfa, Turkey.
Noro Psikiyatr Ars. 2024 May 29;61(2):135-140. doi: 10.29399/npa.28443. eCollection 2024.
Electroconvulsive therapy (ECT) is one of the biological therapies that is well tolerated and has a low risk of complications. Acute cardiovascular complications related to ECT such as ventricular arrhythmia, myocardial infarction and cardiac arrest have been recorded. Increased frontal QRS-T (fQRS-T) angle was associated with ventricular arrhythmia, sudden cardiac death and total mortality. In this study, we aimed to evaluate the effect of ECT on the myocardium using electrocardiography (ECG) parameters such as fQRS-T angle, QRS duration, QT and QTc interval.
A total of 108 patients diagnosed with bipolar disorder (n=36), depressive disorder (n=70) and schizophrenia (n=2) who underwent ECT were included in this study. 12-lead surface ECG of all patients were taken before the ECT, 15 min. after ECT and 24 hour after ECT.
QRS duration, QT interval and corrected QT (QTc) interval were not changed significantly during the follow-up period. However, we found that, fQRS-T angle was significantly increased 15 minutes after ECT compared to baseline angle (p<0.001). We also detected that this increase in fQRS-T angle 15 minutes after ECT was significantly reduced 24 hours after ECT (p=0.031). Meanwhile, there was no significant difference between baseline and 24th hour fQRS-T angle (p=0.154).
In our study, a significant increase in fQRS-T angle was observed 15 min after ECT. However, the fQRS-T angle was found to return to normal after 24 hours. Our findings may indicate that ECT does not have a permanent side effect on the risk of cardiovascular events according to the fQRS-T angle.
电休克治疗(ECT)是耐受性良好且并发症风险较低的生物治疗方法之一。与ECT相关的急性心血管并发症,如室性心律失常、心肌梗死和心脏骤停已有记录。额面QRS-T(fQRS-T)角增大与室性心律失常、心源性猝死和全因死亡率相关。在本研究中,我们旨在使用fQRS-T角、QRS时限、QT和QTc间期等心电图(ECG)参数评估ECT对心肌的影响。
本研究纳入了108例接受ECT治疗的双相情感障碍患者(n = 36)、抑郁症患者(n = 70)和精神分裂症患者(n = 2)。在ECT治疗前、ECT治疗后15分钟和ECT治疗后24小时采集所有患者的12导联体表心电图。
在随访期间,QRS时限、QT间期和校正QT(QTc)间期无明显变化。然而,我们发现,与基线角度相比,ECT治疗后15分钟fQRS-T角显著增大(p < 0.001)。我们还检测到,ECT治疗后15分钟fQRS-T角的这种增大在ECT治疗后24小时显著减小(p = 0.031)。同时,基线和第24小时的fQRS-T角之间无显著差异(p = 0.154)。
在我们的研究中,观察到ECT治疗后15分钟fQRS-T角显著增大。然而,发现fQRS-T角在24小时后恢复正常。我们的研究结果可能表明,根据fQRS-T角,ECT对心血管事件风险没有永久性副作用。