The effect of esmolol on ST-segment depression and arrhythmias after electroconvulsive therapy

David A. Zvara, Robert F. Brooker, William Vaughn McCall, Arthur S. Foreman, Cameron Hewitt, Bryant A. Murphy, Roger L. Royster

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Electroconvulsive therapy (ECT) induces sympathetically mediated hemodynamic alterations that can be associated with myocardial ischemia and arrhythmia generation. Esmolol, a short-acting β-blocker, blunts the hypertension and tachycardia seen with ECT. The purpose of this study is to determine whether esmolol use during ECT reduces the incidence of myocardial ischemia or arrhythmias after ECT. In a randomized, double-blind, placebo- controlled protocol, with each patient acting as his/her own control, the effects of esmolol on the incidence of myocardial ischemia and arrhythmias were studied using two-lead Holter monitoring for at least 2 h post-ECT. Nineteen patients underwent 71 ECT treatments (34 placebo, 37 esmolol), recording 746 h of Holter data. The esmolol group had significantly reduced heart rate and mean arterial pressure immediately after ECT. There was no difference in the incidence of ECG defined ischemia post-ECT between groups, with 7 of 19 (36.8%) patients in the esmolol group showing ST-segment depression compared with 5 of 19 (26.3%) in the placebo group. There was no difference between groups in arrhythmia detection. This experiment demonstrates that (a) ECT is associated with a significant incidence of ST- segment depression, (b) esmolol blunts the sympathetic discharge during ECT, and (c) esmolol does not reduce the incidence of post-ECT ischemia or arrhythmia.

Original languageEnglish (US)
Pages (from-to)165-174
Number of pages10
JournalConvulsive Therapy
Volume13
Issue number3
StatePublished - Oct 23 1997
Externally publishedYes

Fingerprint

Electroconvulsive Therapy
Cardiac Arrhythmias
Incidence
Myocardial Ischemia
Placebos
esmolol
Ischemia
Ambulatory Electrocardiography
Tachycardia
Arterial Pressure
Electrocardiography
Heart Rate
Hemodynamics
Hypertension

Keywords

  • Arrhythmia
  • Electroconvulsive therapy
  • Esmolol
  • Ischemia
  • Monitoring therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Zvara, D. A., Brooker, R. F., McCall, W. V., Foreman, A. S., Hewitt, C., Murphy, B. A., & Royster, R. L. (1997). The effect of esmolol on ST-segment depression and arrhythmias after electroconvulsive therapy. Convulsive Therapy, 13(3), 165-174.

The effect of esmolol on ST-segment depression and arrhythmias after electroconvulsive therapy. / Zvara, David A.; Brooker, Robert F.; McCall, William Vaughn; Foreman, Arthur S.; Hewitt, Cameron; Murphy, Bryant A.; Royster, Roger L.

In: Convulsive Therapy, Vol. 13, No. 3, 23.10.1997, p. 165-174.

Research output: Contribution to journalArticle

Zvara, DA, Brooker, RF, McCall, WV, Foreman, AS, Hewitt, C, Murphy, BA & Royster, RL 1997, 'The effect of esmolol on ST-segment depression and arrhythmias after electroconvulsive therapy', Convulsive Therapy, vol. 13, no. 3, pp. 165-174.
Zvara DA, Brooker RF, McCall WV, Foreman AS, Hewitt C, Murphy BA et al. The effect of esmolol on ST-segment depression and arrhythmias after electroconvulsive therapy. Convulsive Therapy. 1997 Oct 23;13(3):165-174.
Zvara, David A. ; Brooker, Robert F. ; McCall, William Vaughn ; Foreman, Arthur S. ; Hewitt, Cameron ; Murphy, Bryant A. ; Royster, Roger L. / The effect of esmolol on ST-segment depression and arrhythmias after electroconvulsive therapy. In: Convulsive Therapy. 1997 ; Vol. 13, No. 3. pp. 165-174.
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