Cardiac Rhythm Disturbance in a Depressed Patient After Implantation With a Vagus Nerve StimulatorSingleton, Amy H. MD; Rosenquist, Peter B. MD; Kimball, James MD; McCall, W. Vaughn MDJournal of ECT: September 2009 - Volume 25 - Issue 3 - pp 195-197 doi: 10.1097/YCT.0b013e318193e117 Case Reports Abstract Author Information A 52-year-old woman with a long-standing history of treatment-resistant depression failed multiple courses of electroconvulsive therapy and various trials of antidepressant medications. As a result, the patient was deemed a good candidate for vagus nerve stimulation (VNS) therapy and underwent VNS insertion in May 2006. However, in December 2007, she began to experience recurrent falls and was referred to a cardiologist for a syncope evaluation. During a portable 30-day cardiac event recording, she was noted to have intermittent second- and third-degree heart block with ventricular standstill, which was felt by her cardiologist to be associated with VNS stimulation. We believe this to be the first reported case of heart block related to VNS in a depressed patient. From the Department of Psychiatry and Behavioral Medicine, Wake Forest University Health Sciences, Winston-Salem, NC. Received for publication July 14, 2008; accepted October 7, 2008. Reprints: W. Vaughn McCall, MD, MS, Department of Psychiatry and Behavioral Medicine, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27157 (e-mail email@example.com). © 2009 Lippincott Williams & Wilkins, Inc.