Key result
Low-dose atropine effectively blocked vagal tone during electroconvulsive therapy with only a small, likely clinically insignificant rise in myocardial workload compared with placebo.
Why the study?
Does low-dose atropine prevent parasympathetically mediated dysrhythmias without substantially increasing myocardial workload in patients undergoing electroconvulsive therapy?
RCT
Does low-dose atropine prevent parasympathetically mediated dysrhythmias without substantially increasing myocardial workload in patients undergoing electroconvulsive therapy?
Low-dose atropine effectively blocks vagal tone during ECT without causing a clinically significant increase in myocardial workload.
Answers are grounded in this paper and cite their sources.
May support low-dose atropine for vagal blockade in ECT; leaves open confirmation in larger randomized trials.
Anticholinergic medications such as atropine or glycopyrrolate have long been used in electroconvulsive therapy (ECT) to eliminate parasympathetically mediated dysrhythmias. However, such agents increase heart rate and myocardial workload and may increase risk of cardiac adverse events. What is needed is an intervention that is parasympatholytic without substantially increasing myocardial workload. In this study, a low dose of atropine was compared with placebo in ECT with attention to heart rate, blood pressure, cardiac rhythm, myocardial workload, and parasympathetic function. The dose of atropine that was used effectively blocked vagal tone with only a small and probably not clinically significant rise in myocardial workload for only a few minutes after the ECT seizure.
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Rasmussen et al. (1999) conducted an RCT in Patients undergoing electroconvulsive therapy (ECT). Low-dose atropine vs. Placebo was evaluated on Heart rate, blood pressure, cardiac rhythm, myocardial workload, and parasympathetic function. Low-dose atropine effectively blocked vagal tone during electroconvulsive therapy with only a small, likely clinically insignificant rise in myocardial workload compared with placebo.
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