Case of premature ventricular contraction immediately after electroconvulsive therapy in a depressive patient

A 42-year-old woman with eating disorder underwent electroconvulsive therapy (ECT) under general anesthesia with thiamylal 150 mg and suxamethonium 60 mg. On her fourth ECT procedure, premature ventricular contraction (PVC) occurred immediately after the treatment. We speculate that increased release of catecholamine by ECT and hypokalemia caused PVC. It seems that she repeated self-vomiting, because she had hypokalemia, metabolic alkalosis, and weight loss of 3 kg in two weeks before arrhythmia episode. We conclude that in the anesthetic management of patients undergoing ECT a careful attention should be given to body weight change and serum electrolyte care before ECT because it is easy to develop electrolyte abnormality by eating disorder of self-emetic type.