Electroconvulsive therapy can inadvertently induce reversion of atrial fibrillation to sinus rhythm, highlighting the need for careful management to prevent potential embolization.
ECT-associated AF reversion in this case should not change practice; leaves open whether ECT has any therapeutic role in arrhythmia termination.
A case is described in which an elderly male with atrial fibrillation and major depression underwent a course of electroconvulsive therapy. Two of the first three treatments were associated with other arrhythmias, during and after the procedure. Prior to the fourth treatment cardioversion was unsuccessful. During the fourth episode of electroconvulsive therapy, the patient reverted to sinus rhythm and remained in this rhythm. Reversion of atrial fibrillation to sinus rhythm may be associated with embolization if atrial thrombus has formed. Factors predisposing to changes in rhythm with electroconvulsive therapy and the management of patients with atrial fibrillation having electroconvulsive therapy are discussed.
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A. Ottaway (2002) studied this question.
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