Prevention of contrast‐induced bradycardia during coronary angiography

Richards, Kent L.; Browning, Jimmy D.; Hoekenga, David E.

doi:10.1002/ccd.1810070208

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…Brady-arrhythmias have been recognized since the very early experiences and are relatively common during LHC and coronary angiography[ 70 ].Direct toxicity of contrast medium and stimulation of chemoreceptors, other vasovagal reactions induced by pain and anxiety, etc . were the proposed mechanisms of these arrhythmias[ 70 - 72 ].Lately, with the growing popularities of trans-radial catheterization, coiling of the catheters and direct stimulation of the aortic arch and carotid sinus receptors was also noted to cause sinus bradycardia[ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature

Shaik

Slotwiner

Gustafson

et al. 2020

WJC

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BACKGROUND Cardiac catheterization is among the most performed medical procedures in the modern era. There were sporadic reports indicating that cardiac arrhythmias are common during cardiac catheterization, and there are risks of developing serious and potentially life-threatening arrhythmias, such as sustained ventricular tachycardia (VT), ventricular fibrillation (VF) and high-grade conduction disturbances such as complete heart block (CHB), requiring immediate interventions. However, there is lack of systematic overview of these conditions. AIM To systematically review existing literature and gain better understanding of the incidence of cardiac arrhythmias during cardiac catheterization, and their impact on outcomes, as well as potential approaches to minimize this risk. METHODS We applied a combination of terms potentially used in reports describing various cardiac arrhythmias during common cardiac catheterization procedures to systematically search PubMed, EMBASE and Cochrane databases, as well as references of full-length articles. RESULTS During right heart catheterization (RHC), the incidence of atrial arrhythmias (premature atrial complexes, atrial fibrillation and flutter) was low (< 1%); these arrhythmias were usually transient and self-limited. RHC associated with the development of a new RBBB at a rate of 0.1%-0.3% in individuals with normal conduction system but up to 6.3% in individuals with pre-existing left bundle branch block. These patients may require temporary pacing due to transient CHB. Isolated premature ventricular complexes or non-sustained VT are common during RHC (up to 20% of cases). Sustained ventricular arrhythmias (VT and/or VF) requiring either withdrawal of catheter or cardioversion occurred infrequently (1%-1.3%). During left heart catheterizations (LHC), the incidence of ventricular arrhythmias has declined significantly over the last few decades, from 1.1% historically to 0.1% currently. The overall reported rate of VT/VF in diagnostic LHC and coronary angiography is 0.8%. The risk of VT/VF was higher during percutaneous coronary interventions for stable coronary artery disease (1.1%) and even higher for patients with acute myocardial infarctions (4.1%-4.3%). Intravenous adenosine and papaverine bolus for fractional flow reserve measurement, as well as intracoronary imaging using optical coherence tomography have been reported to induce VF. Although uncommon, LHC and coronary angiography were also reported to induce conduction disturbances including CHB. CONCLUSION Cardiac arrhythmias are common and potentially serious complications of cardiac catheterization procedures, and it demands constant vigilance and readiness to intervene during procedures.

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Section: Discussionmentioning

confidence: 99%

Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature

Shaik

Slotwiner

Gustafson

et al. 2020

WJC

View full text Add to dashboard Cite

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Iodinated contrast media

2016

Meyler's Side Effects of Drugs

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Contrast media are the materials utilized in radiology to improve the visualization of certain body structures subjected to analysis in a medical image. Contrast media are, then, diagnostic drugs because they increase the visibility of organs and tissues and allow the identification of details that otherwise could not be observed. With the introduction of multidetector computed tomography the number of patients undergoing contrast studies has grown exponentially in recent years. In computed tomography the formation of the radiographic image is obtained with the use of contrast media containing iodine atoms, exploiting the different attenuation that the X-ray beam presents in crossing the anatomical districts. The Iodinated Contrast Media (ICM) are a category of numerous substances formed by even complex molecules that vary considerably in their properties, uses and toxic effects. Even though iodinated contrast agents have a good safety profile, it is necessary to understand that some patients can have severe, life-threatening allergic reactions because of the side effects of the chemicals. This paper describes the clinical pharmacology, use and adverse reactions of intravenous iodinated contrast media used in computerized tomography, offering all doctors, even non-radiologists, the opportunity for rapid updating.

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Radiological contrast media

Ansell¹

1983

Side Effects of Drugs Annual

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Prevention of contrast‐induced bradycardia during coronary angiography

Cited by 5 publications

References 10 publications

Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature

Intra-procedural arrhythmia during cardiac catheterization: A systematic review of literature

Iodinated contrast media

Radiological contrast media

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