Severe Bradycardia After Anesthesia Before Electroconvulsive Therapy

Departments of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands.
The journal of ECT (Impact Factor: 1.39). 09/2009; 26(1):53-4. DOI: 10.1097/YCT.0b013e3181b00f5b
Source: PubMed


Postanesthesia bradycardia or asystole before electroconvulsive therapy (ECT) occurs very infrequently but is a potentially fatal complication of pre-ECT anesthesia. The optimal strategy for the prevention of its recurrence is unclear because the use of premedication with atropine may not always be successful. In this article, we present the case of a 21-year-old man with schizophrenia who developed bradycardia directly after receiving succinylcholine during the first 3 ECT sessions. Replacing succinylcholine with mivacurium seemed to be a successful strategy in preventing bradycardia during the final 9 ECT sessions.

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Available from: Tom Birkenhager, Jul 21, 2014
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    • "Cardiac arrest during ECT has been reported, though it rarely occurs in current practice [21]. There have been reports of severe bradycardia [22,23] and asystole [22] after anesthesia with succinylcholine before ECT. Similarly, there are reports of cardiac arrest from heart block [3] and pulmonary embolus [14-16] during an ECT. "
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