Key result
An ECT stimulus pulse width of 0.5 msec resulted in higher peak heart rates and more successful seizure induction compared to a 1-msec pulse width.
Why the study?
Does a 0.5 msec pulse width improve stimulus efficiency compared to a 1 msec pulse width in patients receiving ECT?
RCT (n=24)
Does a 0.5 msec pulse width improve stimulus efficiency compared to a 1 msec pulse width in patients receiving ECT?
A 0.5-msec pulse width is more efficient for seizure induction during ECT than a 1-msec pulse width.
May warrant closer cardiac monitoring with shorter-pulse ECT; leaves open optimal parameters for efficacy and safety.
OBJECTIVE: Greater ECT stimulus efficiency allows for a lower stimulus dose and should diminish the side effects of ECT. METHOD: Four different ECT stimuli of identical charge (average mC=2.5 times age) with pulse widths of 0.5 msec and 1 msec and frequencies of 30 Hz and 60 Hz, respectively, were compared for efficiency. The stimuli were applied in a balanced order to each of 24 subjects. Asymmetric bilateral electrode placement was used. RESULTS: Peak heart rates were higher with the 0.5-msec pulse width than the 1-msec pulse width. Seizure induction was more successful with the 0. 5-msec pulse width than the 1-msec pulse width. Stimulus frequency had no effect on heart rate or seizure induction. CONCLUSIONS: The pulse width of 0.5 msec is more efficient than the 1-msec pulse width. The "half-age" dose for the first bilateral ECT treatment is usually successful for subsequent ECTs when the 0.5-msec pulse width is used.
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Swartz et al. (2000) reported an RCT. ECT stimulus with 0.5-msec pulse width vs. ECT stimulus with 1-msec pulse width was evaluated on Peak heart rate and seizure induction. An ECT stimulus pulse width of 0.5 msec resulted in higher peak heart rates and more successful seizure induction compared to a 1-msec pulse width.
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