ECT in a Left Ventricular Assist Device Recipient With Treatment-Resistant Depression: Case Report in JECT

 Out on PubMed, from authors in North Carolina, in JECT, is this case report:


Electroconvulsive Therapy in a Left Ventricular Assist Device Recipient With Treatment-Resistant Depression.

Nash R, Rosenkrans D, Kolarczyk L, Khan A, Hatch E, Gala G, Laughon SL, McClure RK.J ECT. 2024 Nov 6. doi: 10.1097/YCT.0000000000001080. Online ahead of print.PMID: 39531309
The abstract is copied below:
Depression and heart failure are highly comorbid, with up to 35% of heart failure patients suffering from comorbid depression. Left ventricular assist devices (LVADs) serve as a major lifeline for patients with heart failure; however, despite the drastic improvement in cardiac function following LVAD implantation, up to 24% of LVAD recipients suffer from depression. Depression management in LVAD recipients is often complicated by the recipient's increased risk for antidepressant side effects, adverse drug reactions, and inability to safely receive certain interventional psychiatry therapies, as the LVAD is either a relative or absolute contraindication. Electroconvulsive therapy (ECT) is highly effective for treatment-resistant depression; although it carries increased cardiovascular risks for the LVAD population (particularly bradycardia/hypotension and tachycardia/hypotension), these can be continuously monitored, along with LVAD function, such that with the close cooperation of a multidisciplinary team, the risks of ECT can be minimized. To our knowledge, there is only one published case report of ECT in an LVAD recipient. We present a case of an LVAD recipient with treatment-resistant depression who was successfully treated with ECT. Our case describes an approach by which ECT can be safely delivered to LVAD recipients with a collaborative multidisciplinary team approach.

The report is here.
And from the text:


This is highly detailed case report that is apparently only the second of its kind in the literature. The cardiology and anesthesiology management details may be helpful to practitioners faced with similar situations in the future.
Kudos to our UNC colleagues for sharing thier experience in the ECT literature.

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