Psychosomatics | 2019
Asystole a Few Seconds After the Electrical Stimulation of Electroconvulsive Therapy.
Abstract
Abstract Asystole during electroconvulsive therapy (ECT) occurs occasionally and is potentially harmful. Asystole typically happens immediately after the electrical stimulation due to excessive parasympathetic nervous system activity by direct stimulation of the vagus nerve. A case of a woman with depression and strong suicidal ideation who showed asystole during an ECT seizure is presented. Her 15-sec-long asystole did not occur immediately after the ECT stimulation, but 11\xa0sec after the stimulation. Her electrocardiogram suggested that her asystole was due to excessive parasympathetic nervous system activity, similar to common asystole during ECT. The results of a later interview led us to assume that she had carotid sinus syndrome. The excessive parasympathetic nervous system activity caused by carotid sinus hyperactivity reacting to blood pressure elevation by an ECT seizure was assumed to be the cause of her asystole. With atropine premedication, she could continue the ECT course without further asystole. She recovered with the completed ECT course.