Improving relapse prevention after successful electroconvulsive therapy for patients with severe depression: completed audit cycle involving 102 full electroconvulsive therapy courses in West Sussex, United kingdom.

Objectives: The aim of this study was to determine whether current guidance or consensus regarding continuation pharmacotherapy after successful electroconvulsive therapy (ECT) was being followed by referring clinicians in West Sussex, United Kingdom.

Methods: A complete audit cycle examining psychotropic medication after successful ECT for patients with severe depression was performed. Clinical and ECT records (electronic and paper) were reviewed, and relapse rates in the 4 commonly prescribed psychotropic medication groups were compared.

Swallow syncope associated with paroxysmal atrial fibrillation.

Swallow or deglutition syncope is a very unusual potentially lethal but treatable disorder. We report the case of a 26-year-old woman, who presented with a history of recurrent, multiple fainting episodes precipitated by swallowing. Twenty-four-hour manometry and pH recording together with continuous 24-h ECG monitoring revealed multiple episodes of symptomatic and asymptomatic paroxysmal atrial fibrillation, and significant gastro-oesophageal reflux associated with swallowing.