Key result
Bifrontal electrode placement during electroconvulsive therapy resulted in 0% incidence of asystole, compared to 63% with right unilateral placement.
Why the study?
Does bifrontal electrode placement prevent asystole compared to unilateral or bitemporal placement during electroconvulsive therapy?
Observational (n=120)
Does bifrontal electrode placement prevent asystole compared to unilateral or bitemporal placement during electroconvulsive therapy?
Bifrontal electrode placement during electroconvulsive therapy appears to prevent the vagal activation and subsequent asystole frequently observed with unilateral placement.
Answers are grounded in this paper and cite their sources.
Bifrontal placement was associated with absent asystole; leaves open whether it should replace unilateral ECT pending randomized confirmation.
Cardiac action was monitored during the stimulation period of 120 consecutive electroconvulsive therapies. Electrode placement was right unilateral in 73, bitemporal in 11, and bifrontal in 36 cases. Anticholinergic premedication was routinely given. A reduction in heart rate was seen consistently with unilateral electrode placement and asystole longer than 2 seconds occurred in 63% of cases. In contrast, no asystole occurred with bifrontal electrode placement. Thus, the vagus nerve seems to be less activated during bifrontal stimulation.
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Josef Nagler (2010) conducted an observational in Patients undergoing electroconvulsive therapy (n=120). Bifrontal electrode placement vs. Right unilateral electrode placement was evaluated on Asystole longer than 2 seconds. Bifrontal electrode placement during electroconvulsive therapy resulted in 0% incidence of asystole, compared to 63% with right unilateral placement.
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