Classics in ECT: Cardiac Letters to Zielinski et al., Am J Psych, 1994

 "Classics in ECT" brings you this series of LTEs in the Green Journal, 1994:

Cardiovascular complications of ECT.

Stoudemire A.Am J Psychiatry. 1994 May;151(5):790; author reply 791.PMID: 8166341 

The letters are here:

Here are three LTEs in response to the classic Zielinski et al. cardiac ECT article from 1993.

Myself/Mark Beale, Stoudemire et al. and Figiel et al. argue for more use of cardioprotective agents in selected patients; the Devanand et al. reply is somewhat more conservative/cautious, but generally in polite agreement.

The ensuing decades I believe have brought cardiac management more in line with the opinions of the three responsive letter writers, with the exception of the demise of nitroglycerine paste/spray/pills in most ECT practices.

I am glad to be reminded that the Zielinski classic is from the Sackeim Columbia group and of the active dialog facilitated by the American Journal of Psychiatry.