The safety of electroconvulsive therapy in patients with prolonged QTc intervals on the electrocardiogram

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.