ECT and heart rate changes: An alternative to EEG monitoring for seizure confirmation during modified ECT

Abstract

Background: Detection of seizure demands attention in modified ECT, because of muscle relaxation. The "cuff method" is not always reliable, as it may sometimes fail to detect seizures of adequate duration. Aim: To examine if increase in heart rate can be an additional guide to detect adequate cerebral seizures. Method: Heart rates before and following the stimulus were estimated in 100 ECT sessions (52 patients) of adequate (60) and inadequate (40) EEG seizures. The peak heart rate, the ratio of peak to the baseline heart rate and time required to reach peak were obtained for each of these recordings. Result: The group with adequate EEG seizure had significantly higher peak heart rate, higher peak to baseline heart rate ratio and longer time to reach peak heart rate. Conclusion : The time required to reach the peak heart rate along with normalized peak heart rate (the ratio of baseline to peak heart rate) in that order can be additional measures to detect adequate seizure during modified ECT.