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Heart Rate Variability in Elderly Patients Before and After Electroconvulsive Therapy

Received November 19, 1999; revised August 2, 2000; accepted August 29, 2000. From the Psychogeriatrics Department and Research Unit, Geha Psychiatric Hospital, and the Institute of Cardiology, ICCU, Beilinson Hospital, Campus Beilinson, Petah Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Address correspondence to Dr. Nahshoni, Geha Psychiatric Hospital, P.O.B 102, Petah Tikva 49100, ISRAEL. e-mail: green175{at}netvision.net.il

Earlier studies have found major depression to be associated with increased cardiac mortality, hypothesized to result from reduced vagal modulation. Since reduced heart rate variability is part of normal aging, depression might predispose elderly patients to a higher risk. The authors investigated cardiac autonomic modulation, using spectral analysis, in 11 elderly depressed inpatients before and after electroconvulsive therapy (ECT). Cardiac vagal modulation increased significantly after ECT and was associated with symptom improvement, assessed by a significant decrease in the Hamilton Rating Scale for Depression. Further research is needed to elucidate the relationship between depression, autonomic modulation, and clinical risks in elderly patients.

Key Words: ECT • Depression • Cardiac Factors

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