Diffuse T-wave inversions associated with electroconvulsive therapy

Electroconvulsive therapy (ECT) can lead to ST depression and arrhythmias in patients with coronary artery disease, most likely secondary to increased myocardial oxygen demand. This report describes a case of ECT-associated, global T-wave inversions in a patient with chronic atrial fibrillation treated with digoxin. Laboratory evaluation and echocardiography were normal. These T-wave changes may result from increased sympathetic activity associated with ECT. Prospective studies suggest that this finding may be seen in up to 4% of patients undergoing ECT.