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Incidence of Asystole in Electroconvulsive Therapy in Elderly Patients

Received April 24, 1996; revised September 3, 1996; accepted December 10, 1997. From the Karl Menniger School of Psychiatry, Topeka, KS. Address correspondence to Dr. Kettl, Department of Psychiatry, Penn State University College of Medicine, P.O. Box 850, Hershey, PA 17033.

The authors prospectively investigated the incidence of asystole (absence of heartbeat for 5 seconds) in elderly patients receiving electroconvulsive therapy (ECT) at a university-based geriatric psychiatry unit. In all, 65.8% of patients experienced asystole at some time during their course of ECT. Those who experienced asystole were significantly younger (average age, 72.2) than those without asystole (average age, 77.0; P=0.026) and were also less likely to have cardiac rhythm disturbances on electrocardiogram (P=0.024). Medical history, history of cardiac disease, electrode placement, energy level, and number of ECT treatments did not predict asystole. Asystole is a common side effect of ECT in elderly patients. It was not associated with any untoward outcome. The fact that "old-old" patients and those with cardiac disease are less likely to experience asystole than younger, healthier patients is reassuring to practitioners of ECT.

Key Words: Electroconvulsive Therapy (ECT) • Asystole • Elderly Patients

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