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Atrioventricular Dissociation after Electroconvulsive Therapy英文文献资料.doc

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Atrioventricular Dissociation after Electroconvulsive Therapy英文文献资料

SAGE-HindawiAccesstoResearch CardiologyResearchandPractice Volume2011,ArticleID746373,4pages doi:10.4061/2011/746373 CaseReport AtrioventricularDissociationafterElectroconvulsiveTherapy SiegfriedWilliamYu, SrikanthVallurupalli, JenniferArnoldi, andRichardHolloway 1 1 2 3 1 2 3 DepartmentofInternalMedicine,SouthernIllinoisUniversitySchoolofMedicine,Spring?eld,IL62711,USA SchoolofPharmacology,SouthernIllinoisUniversityEdwardsvilleandSt.John’sHospital,Spring?eld,IL62711,USA SouthernIllinoisUniversitySchoolofMedicineandPrairieCardiovascularConsultants,Spring?eld,IL,USA CorrespondenceshouldbeaddressedtoSiegfriedWilliamYu,syu2.siumed@ Received2March2011;Revised15July2011;Accepted16July2011 AcademicEditor:GavinW.Lambert Copyright?2011SiegfriedWilliamYuetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Electroconvulsivetherapy(ECT)isincreasinglyusedasatreatmentforpsychiatricdisorders.Cardiace?ectsaretheprincipal causeofmedicalcomplicationsinthesepatients.Wereportacaseofatrioventricular(AV)dissociationthatoccurredafterECT thatwastreatedwithpacemakerimplantation.ThemechanismscontributingtotheonsetofAVdissociationinthispatient,and themanagementandrationalefordevicetherapy,inlightofthemostrecentguidelines,arereviewed. 1.Introduction werediscontinued,andescitalopramandmirtazapinewere added.Becauseherdepressionwasresistanttomedicalther- apy, ECT was pursued. Her baseline ECG (see Figure1) demonstrated sinus rhythm, with a right bundle branch block (RBBB) pattern and Q waves in leads III and aVF suggestingapreviousinferiorinfarct.ThePRintervalwas normalat160milliseconds(ms).Hydrochlorothiazideand amlodipinewereprescribedforheruntreatedhypertension. She was started on three sessions of unilateral ECT a week, with a frequency of 60 hertz and a current of 800 milliamperes.Premedica