Mechanism of the bradycardia during coronary angiography

Frink, Richard J; Merrick, B. Alex; Löwe, H

doi:10.1016/0002-9149(75)90553-6

Cited by 30 publications

(6 citation statements)

References 18 publications

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“…In some experimental and clinical studies, right coronary injection has been found to cause greater prolongation of the RR interval than left coronary injection, and this was attributed to the fact that the sino-atrial node is directly affected by the right-sided injection of CM (4,5). The present study, however, revealed that there was no significant difference between right and left coronary angiography, except for ioxaglate.…”

Section: Resultscontrasting

confidence: 70%

“…They are the hypertonicity, ionicity, and the chemical structure of the iodinized anion or iodinized molecule (1), and the last one has so far been regarded as less significant than the other two factors (1). Regarding transient bradycardia, the hypertonicity of CM has been said to be the most responsible for this phenomenon (1,5). In the present study, ioxaglate caused a significantly smaller bradycardiaI effect than the other three CM, including two low osmolality non-ionic agents.…”

Section: Resultsmentioning

confidence: 51%

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Effects of Contrast Media on the RR and QT Interval during Coronary Arteriography

Mitsumori

Hayakawa²,

Soga³

et al. 1991

Acta Radiol

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During coronary arteriography, transient prolongation of the RR and QT intervals can be observed to occur. Animal experiments have suggested that low-osmolality contrast media have less effect, but there have been few clinical studies of this phenomenon. We analyzed 95 electrocardiographic records from patients who had undergone coronary arteriography and assessed the maximal prolongation of the RR and QT intervals. The contrast media used for arteriography included meglumine sodium diatrizoate, iopamidol, iohexol, and meglumine sodium ioxaglate. Diatrizoate caused the greatest electrocardiographic changes. Among the low osmolality contrast media, ioxaglate caused the smallest bradycardial effect and iohexol the smallest prolongation of the QT interval. It appears necessary to consider some additional factors for osmolality or ionicity, such as the chemotoxicity of the chemical structure of the iodinated contrast medium moiety, when assessing their potential adverse effect on the cardiac conduction system.

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Section: Resultscontrasting

confidence: 70%

Section: Resultsmentioning

confidence: 51%

Effects of Contrast Media on the RR and QT Interval during Coronary Arteriography

Mitsumori

Hayakawa²,

Soga³

et al. 1991

Acta Radiol

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“…cardiac receptors during coronary angiography in man was first shown by Eckberg et al (1974) and later confirmed by Frink et al (1975), Zelis et al (1976), and Perez-Gomez and Garcia-Aguado (1977). Mainly of reflex origin, the bradycardia is also partly due to a direct effect on the sinus node.…”

Section: Bezolddarisch Reflexes During Coronary Angiography Activatimentioning

confidence: 80%

Role of cardiac vagal c-fibers in cardiovascular control

Thorén

1979

Reviews of Physiology, Biochemistry and Pharmacology

437

162

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“…The persistence of such changes despite prophylactic atropine suggests that this effect of contrast media is direct and not mediated via the autonomic nervous system. The major effects of contrast agents on cardiac rhythm are, however, thought to be mediated indirectly by the vagus nerve [2,3,1 I] or by direct depressant effect of contrast media on the sinoatrial node [3,9]. The effects of contrast material on atrioventricular node function have not been studied in detail but previously have been reported to be clinically unimportant [121.…”

Section: Discussionmentioning

confidence: 99%

Prevention of contrast‐induced bradycardia during coronary angiography

Richards

Browning

Hoekenga

1981

Cathet. Cardiovasc. Diagn.

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A double-blind study of 90 patients undergoing coronary angiography was performed to determine the safety and efficacy of 0.6 mg atropine sulfate in preventing contrast-induced bradycardia. Coronary angiography performed using the Sones technique resulted in ventricular pauses of greater than 2 seconds in 3 of 49 patients (6%) who received prophylactic atropine and 20 of 41 patients (49%) receiving placebo. Though the pauses were usually due to atrial asystole, 26% of those with greater than 2 second pauses did so because of transient complete heart block. Prophylactic atropine did increase resting heart rate but did not cause other arrhythmias or increase the frequency of angina pectoris despite the presence of severe coronary disease. Our data indicate that contrast-induced asystole is very common, cannot be predicted by consideration of "precatheterization data," and can be prevented effectively and safely by use of prophylactic atropine sulfate.

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Mechanism of the bradycardia during coronary angiography

Cited by 30 publications

References 18 publications

Effects of Contrast Media on the RR and QT Interval during Coronary Arteriography

Effects of Contrast Media on the RR and QT Interval during Coronary Arteriography

Role of cardiac vagal c-fibers in cardiovascular control

Prevention of contrast‐induced bradycardia during coronary angiography

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