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Electroconvulsive therapy and electrocardiograph changes

A 70-year-old woman with a body mass index of 25 kg/m 2 and recalcitrant depression on a background of quiescent polycythemia rubra vera and carcinoma breast was scheduled for electroconvulsive therapy (ECT). Her current medications were aspirin 150 mg mane on alternative days, quetiapine 50 mg BD and nitrazepam 60 mg nocte. Her pulse was 80 bpm with BP of 130/70 mHg and the baseline electrocardiograph (ECG) is shown in [Figure 1]. Under anesthetic supervision, she was administered bifrontal 50% ECT. Immediately following ECT, a 22-sec motor seizure was noted. She developed atrial fibrillation with a ventricular rate of 130 bpm with 4-mm diffuse T-wave inversion. She was treated with 135 mg ...

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