The stimulus leads to increases in cerebral blood flow and increased ICP. Initially, the seizure activity causes a large parasympathetic discharge with bradycardia, atrial or ventricular premature beats, and occasional asystole. This is followed by sympathetic discharge causing tachycardia (maximal at two minutes), hypertension, ST-segment depression and T-wave inversion not associated with myocardial enzyme changes, and rarely ventricular tachycardia. According to Miller ,”ECT has been found to be relatively safe even in high-risk cardiac patients, if careful management is provided.”
Glucose homeostasis is affected variably with both improved and worse control – interestingly, patients with NIDDM generally experience better control, whereas those with IDDM experience worse control.
ECT: Side Effects
- Initial parasympathetic response
- Sympathetic discharge (maximal at two minutes)
- EKG changes unaccompanied by enzyme leak
- Alterations in glucose control