The Safety and Strategies for Reinitiating Electroconvulsive Therapy (ECT) After ECT-Induced Takotsubo Cardiomyopathy : A Case Report and Systematic Review
木下, 倫子 Tokushima University 徳島大学 教育研究者総覧
木下, 誠 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
Takahashi, Rikako Tokushima University
Mutoh, Sarara Tokushima University
角田, 奈美 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
田中, 克哉 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
Takotsubo cardiomyopathy (TCM) is a life-threatening complication of electroconvulsive therapy (ECT). We report the case of a 66-year-old woman who was re-challenged with ECT after ECT-induced TCM. Moreover, we have made a systematic review to assess the safety of and strategies for re-initiating ECT after TCM.
We searched for published reports on ECT-induced TCM since 1990 in MEDLINE (PubMed), Scopus, Cochrane Library, ICHUSHI, and CiNii Research.
A total of 24 ECT-induced TCM cases were identified. Patients who developed ECT-induced TCM were predominantly middle-aged and older women. There was no specific trend in anesthetic agents used. Seventeen (70.8%) cases developed TCM by the third session in the acute ECT course. Eight (33.3%) cases developed ECT-induced TCM despite the use of β-blockers. Ten (41.7%) cases developed cardiogenic shock or abnormal vital signs related to cardiogenic shock. All cases recovered from TCM. Eight (33.3%) cases tried to receive ECT retrial. The duration until ECT retrial was between 3 weeks and 9 months. The most common preventive measures during ECT retrial were related to β-blockers; however, the type, dose, and route of administration of β-blockers varied. In all cases, ECT could be re-performed without TCM recurrence.
ECT-induced TCM is more likely to cause cardiogenic shock than non-perioperative cases; nevertheless, it has good prognosis. Cautious re-initiation of ECT after TCM recovery is possible. Further studies are required to determine preventive measures for ECT-induced TCM.
The Journal of ECT
Wolters Kluwer Health
This is a pre-copyedited, author-produced version of an article accepted for publication in The Journal of ECT. The published version of record Kinoshita, Michiko MD, PhD∗; Kinoshita, Makoto MD, PhD†; Takahashi, Rikako MD∗; Mutoh, Sarara MD∗; Kakuta, Nami MD, PhD∗; Tanaka, Katsuya MD, PhD∗. The Safety and Strategies for Reinitiating Electroconvulsive Therapy After ECT-Induced Takotsubo Cardiomyopathy: A Case Report and Systematic Review. The Journal of ECT ():10.1097/YCT.0000000000000905, January 30, 2023. is available online at: https://doi.org/10.1097/YCT.0000000000000905.