Electroconvulsive Therapy in Patients With Cardiac Implantable Electronic Devices: A Case Report and Systematic Review of Published Cases

• Published in: The journal of ECT Vol. 39; no. 1; pp. 46 - 52
• Main Authors: Purohith, Abhiram Narasimhan, Vaidyanathan, Sivapriya, Udupa, Suma T., Munoli, Ravindra N., Agarwal, Sheena, Prabhu, Mukund A., Praharaj, Samir Kumar
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-03-2023
• Subjects: Depression; Depressive Disorder, Major - therapy; Electroconvulsive Therapy - adverse effects; Humans; Hypertension; Male; Middle Aged
• ISSN: 1095-0680; 1533-4112
• DOI: 10.1097/YCT.0000000000000851

The aims of the study were to report the case of a 54-year-old man with recurrent depressive disorder with multiple medical comorbidities having a dual-chamber pacemaker, treated successfully with 11 sessions of electroconvulsive therapy, and to conduct a systematic review of published cases documenting the use of electroconvulsive therapy (ECT) in patients with cardiac implantable electronic devices (CIEDs) for treating major psychiatric disorders.
We searched electronic databases (MEDLINE, PubMed, Google Scholar, Embase, Cochrane Library, PsycINFO, and Crossref) and included studies reporting on the use of electroconvulsive therapy in patients with CIEDs.
Thirty-five publications across 53 years (1967-2021) reported on 76 patients (including current report) who received a pooled total of 979 modified ECT sessions. The most common adverse events were premature ventricular contraction and hypertension. There have been no reports of serious adverse effects that necessitated the cessation of ECT.
Electroconvulsive therapy is a safe and efficacious treatment for major psychiatric disorders, and the presence of CIEDs should not delay or deter the use of ECT in these patients.