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The Safety of Electroconvulsive Therapy in Patients With Prolonged QTc Intervals on the Electrocardiogram

Pullen, Samuel J. DO*; Rasmussen, Keith G. MD*; Angstman, Elizabeth R. BS; Rivera, Fernando MD; Mueller, Paul S. MD

doi: 10.1097/YCT.0b013e31821d3911
Original Studies

Background: Prolonged QTc intervals have been associated with increased cardiac morbidity and mortality. We investigated whether pretreatment prolongation of the QTc interval was associated with increased cardiac-related events (CREs) in electroconvulsive therapy (ECT) treatment of psychiatric disorders.

Methods: The charts of 1437 ECT patients were reviewed for the presence of baseline QTc prolongation. Broadly defined CREs during the course of treatment were abstracted from patient charts.

Results: Presence of baseline QTc prolongation was not independent of increased risk of CREs during ECT.

Implications: Careful consideration should be given to patients who have QTc prolongation on an electrocardiogram and are undergoing ECT treatment, but this should not definitively exclude patients from receiving ECT treatment.

From the *Department of Psychiatry and Psychology; †Mayo Medical School; and ‡Department of General Internal Medicine, Mayo Clinic, Rochester, MN.

Received for publication October 18, 2010; accepted March 21, 2011.

All authors have no commercial, financial, or industry support to disclose.

Reprints: Keith G. Rasmussen, MD, Mayo Clinic, 200 First ST SW, Rochester, MN 55905 (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.