Evaluating effects of ECT on cardiac function
Research type
Research Study
Full title
Effects of electroconvulsive therapy (ECT) on cardiac function, as assessed with 12 lead ambulatory electrocardiography (ECG) holter and signal averaging.
IRAS ID
350883
Contact name
Stuart Rosen
Contact email
Sponsor organisation
London Northwest University Healthcare NHS Trust
Clinicaltrials.gov Identifier
Pending, Pending
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
In the UK, NICE guidelines recommend the use of electroconvulsive therapy (ECT) for severe depression, especially when other treatments have failed or when there is an immediate life-threatening risk. ECT is also recommended for other psychiatric conditions including mania, catatonia and schizophrenia. ECT uses a small electric current to intentionally induce a brief seizure, typically lasting 30-60 seconds, which may lead to improvements in mood and thought regulation, through mechanisms which are not clearly understood.
We would like to study the effect of ECT on cardiac function as assessed by 12 lead holter recordings captured immediately before ECT stimulus, during the evoked seizure and shortly after seizure. This can also be correlated with continuous recordings of HR and BP. Additionally, using signal averaged ECG could allow detection of a larger number of independent ECG components and a more comprehensive understanding of cardiac electrical activity patterns. This study could aid identification of adverse cardiac consequences associated with ECT on individuals with depression, that have not previously been detected on 12 lead ECG alone.
We propose that, as a reproducible model of one form of generalised seizure, our findings could offer ECG surrogates of pro-arrythmia and therefore be more broadly applied to enhance our understanding of SUDEP. The exact causes of SUDEP are not well established, but proposed causes include cardiac arrhythmias, changes in HR and autonomic nervous system dysregulation.
Only patients undergoing ECT for depression with the capacity to consent would be eligible. ECT typically entails an initial regime of 2 sessions a week for 6 weeks. Eligible patients may be undergoing ECT at any stage of their standard course, which would additionally allow identification of any cardiac changes with repeated seizures as the treatment course progresses. Our study would be conducted in the ECT suite located in an NHS hospital.
REC name
London - West London & GTAC Research Ethics Committee
REC reference
25/LO/0651
Date of REC Opinion
18 Nov 2025
REC opinion
Further Information Favourable Opinion