A Case of Psychotic Depression in a Patient with a Cardiac Pacemaker Successfully Treated with Modified Electroconvulsive Therapy

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  • 修正型電気けいれん療法が奏効したペースメーカーを植込まれた精神病性うつ病の1例

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Herein, we present a 66-year-old man with a pacemaker who was successfully treated for psychotic depression using modified electroconvulsive therapy (mECT). The patient received a pacemaker at the age of 55 due to severe arrhythmia. He had struggled with depression since the age of 58 and had experienced recurrent depression. Four months prior to admission to our psychiatric department, he began to show psychotic symptoms as well as severe depressive symptoms. On the day of admission, he was evaluated for mECT because he showed no response to drug treatment. Five courses of mECT were conducted, during which cardiac and pacemaker functions were closely monitored. An immediate improvement in psychiatric symptoms was observed, and no arrhythmia or pacemaker malfunction was detected following the mECT sessions. In addition, it was not necessary to convert the pacemaker to a fixed rate pacing or deactivate the pacemaker before mECT. Consequently, the presence of a pacemaker should not be considered a contraindication for mECT.

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