Short-Term Adverse Cardiovascular Events After Electroconvulsive Therapy

Background Electroconvulsive Therapy (ECT) is a pivotal treatment for severe psychiatric disorders, including Major Depressive Disorder (MDD) and bipolar disorder. Despite its effectiveness, there have been cases of adverse cardiac events reported following ECT. The primary objective of this study was to determine the correlation of short term adverse cardiac events amongst those with and without cardiac comorbidities. Methods This retrospective cohort study utilized data collected from HCA Healthcare. The primary endpoint was incidence of adverse cardiac events, including angina, arrhythmia, heart failure, and myocardial infarction. Data was collected using ICD 9 and 10 codes and unique subject codes for ECT. Demographic information was characterized by age, length of stay, sex, and race/ethnicity; our study excluded pregnant patients. Results This study analyzed 146,575 ECT treatments administered to 37,721 patients between 2015 and 2022. The study identified a low adverse cardiac event rate of 0.44% per ECT treatment, encompassing events like angina, arrhythmia, heart failure, and myocardial infarction. Of the 640 total cardiac events, 168 (26%), 201 (31%), and 277 (43%) events were observed in patients with known hypertension, hyperlipidemia, and arrhythmias, respectively, while 472 (74%), 439 (69%), and 363 (57%) events were observed in patients with no previously diagnosed hypertension, hyperlipidemia, arrhythmia, respectively. Conclusions While ECT procedures are known to induce transient hemodynamic fluctuations and potentially trigger minor cardiac events, these findings align with previous literature showing similar results, reinforcing ECT’s safety as a therapeutic option for patients with complex psychiatric conditions.