Assessment of cardiac autonomic activity by studying heart rate variability in adult psychiatric patients subjected to electroconvulsive therapy

Abstract

The autonomic nervous system (ANS) plays a crucial role in normal functioning of the heart and is responsible for normal cardiac variability, which can be studied by recording (HRV) heart rate variability. HRV is an excellent, noninvasive tool used to show variation over time of period between consecutive heart beats and for assessment of cardiovascular regulation of ANS. Available literature is insufficient to document effect of Electroconvulsive therapy (ECT) on HRV in psychiatry patients. To explore the effect of ECT on HRV with a view to assess the safety of ECT in various age groups of patients requiring ECT. This Non-Randomized comparison study without a control was conducted at a tertiary care teaching hospital in Ludhiana Punjab in 100 cases of ECT over a period of 2 years. A detailed general physical examination as well as systemic examination was done and observations were documented. Each patient was screened for indication for the ECT by the Psychiatrist. HR prior to ECT and HRV in immediate post procedure period were noted. This study indicates that heart rate increased significantly after ECT but this variation remains within the homeostatic limits. Although the study shows safety of ECT in psychiatric patients, it would be advisable to monitor HRV in ECT given in pre-existing cardiac illness.