ArticleJACC. Case reports2025
Fragile X and Fatal Rhythms: Electroconvulsive Therapy-Induced Ventricular Tachycardia.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundFragile X syndrome (FXS) is associated with autonomic dysfunction and ion channel abnormalities that increase the risk of arrhythmias. Electroconvulsive therapy (ECT), used to treat catatonia in FXS, can trigger a sympathetic surge, potentially inducing ventricular tachycardia. CASE SUMMARY: A 52-year-old man with FXS and catatonia developed recurrent wide complex tachycardia and cardiac arrest during ECT sessions, despite normal electrolytes, no structural heart disease, and a normal baseline electrocardiogram. The patient had recurrent cardiac arrest despite scheduled oral amiodarone 200 mg 3 times a day and premedication with 30 mg of esmolol. Pretreatment with a left stellate ganglion block and intravenous amiodarone infusion was considered before ECT sessions. DISCUSSION: FXS may increase susceptibility to arrhythmia owing to elevated sympathetic tone and channelopathies associated with fragile X mental retardation protein. ECT may amplify this risk, requiring proactive strategies. TAKE-HOME MESSAGES: Patients with FXS may require individualized pre-ECT risk assessment. Antiarrhythmic and sympathetic modulation strategies, including stellate ganglion block, may be essential for arrhythmia prevention in high-risk cases.
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