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Infarction and Coronary Insufficiency During Electroconvulsive Therapy

Paul H. Blachly, MD
JAMA. 1968;206(1):135. doi:10.1001/jama.1968.03150010082033.
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To the Editor:—  The interesting article by Drs. Hussar and Pachter draws our attention to the following newer findings and techniques not mentioned:

  1. Complete paralysis of the patient with succinylcholine and continuous ventilation with oxygen during the seizure as monitored by a cathode ray oscilloscope in the operating room decreases the likelihood of triggering a cardiac arrhythmia by hypoxia and alerts one for active intervention should a cardiac irregularity of serious import develop during the treatment.1-4

  2. The continuous ventilation during the seizure prevents the build-up of carbon dioxide which may raise blood pressure unduly.

  3. The presence of a cardiac defibrillator in the room or quickly available permits the active correction of certain cardiac arrhythmias if the electrocardiogram is monitored during the procedure.

  4. The use of atropine administered intravenously shortly before the treatment rather than administering it subcutaneously prevents errors in administration by nonphysicians. The monitoring of


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