Why the study?
Does bilateral ECT compared to unilateral ECT result in a greater acute increase in rate pressure product in patients undergoing ECT?
Does bilateral ECT compared to unilateral ECT result in a greater acute increase in rate pressure product in patients undergoing ECT?
Bilateral ECT induces a significantly greater acute increase in myocardial oxygen demand (rate pressure product) than unilateral ECT, though both modalities appear safe without acute cardiovascular complications.
Bilateral ECT was associated with greater postictal RPP rise than unilateral; leaves open implications for cardiac risk stratification in ECT.
The effect of electrode placement on cardiovascular responses was studied. Rate pressure product and diastolic blood pressure before anesthesia and 30 s after electroconvulsive therapy (ECT) seizure were recorded. Recordings were made at the first (threshold ECT) session in 124 bilateral ECT (BLECT) and 95 unilateral ECT (ULECT) consenting patients. Postictal rate pressure product (RPP) was significantly higher after BLECT than ULECT. Mean increase in RPP from pre- to postictal phase was 31% in the former. The corresponding change with ULECT (20%) was significantly smaller. In the stepwise, multiple regression model, pre-ECT RPP, age, and stimulus laterality significantly contributed to postictal RPP. No cardiovascular complications occurred in any of the 219 ECT sessions.
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Mayur et al. (1998) studied this question.
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