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ECG changes during cerebral angiography; a comparison of low osmolality contrast media
M Mitsumori1, K Hayakawa, M Abe
1Department of Radiology, Faculty of Medicine, Kyoto University, Japan.
Insights
Cerebral angiography using low osmolality contrast media (CM) can cause heart rate changes. Younger, unpremedicated patients are more prone to bradycardia, while ioxaglate showed a higher urticaria incidence.
Area of Science:
- Cardiology
- Radiology
- Pharmacology
Background:
- Cerebral angiography is a common diagnostic procedure.
- Low osmolality contrast media (CM) are widely used.
- Electrocardiographic (ECG) and adverse effects of CM require evaluation.
Purpose of the Study:
- To analyze ECG changes and adverse effects associated with low osmolality CM during cerebral angiography.
- To identify patient factors influencing these effects.
Main Methods:
- Analysis of 334 ECG recordings from 109 patients undergoing cerebral angiography.
- Evaluation of CM types: meglumine sodium ioxaglate, iopamidol, and iohexol.
- Assessment based on patient age, premedication with atropine sulfate, and injected vessel.
Main Results:
- Tachycardia (>10%) occurred in 8.3% of recordings; bradycardia (>10%) in 11.1%.
- Younger (<19 years) and unpremedicated patients showed significantly higher bradycardia incidence.
- No significant ECG abnormalities differences between CM types or injected vessels.
- Urticaria incidence was significantly higher (11.9%) with ioxaglate compared to other CM.
Conclusions:
- Low osmolality CM can induce significant heart rate alterations during cerebral angiography.
- Patient age and premedication are key factors influencing bradycardia risk.
- Ioxaglate is associated with a higher incidence of urticaria compared to iopamidol and iohexol.
Abstract:
334 electrocardiographic recordings obtained from 109 patient who underwent cerebral angiography with low osmolality contrast media (CM) were analysed. CM used in this study included meglumine sodium ioxaglate, iopamidol, and iohexol. A tachycardial effect greater than 10% was seen in 8.3% of recordings, while a bradycardial effect greater than 10% was seen in 11.1%. Assessment was based on the type of CM used, age of the patients, usage of atropine sulfate as premedication, and the vessel injected. Patients who were under 19 years of age, and unpremedicated had a significantly higher incidence of bradycardia. On the other hand, there was no significant difference of the incidence of electrocardiographic abnormality between the three CM, and between two injected vessel groups. We have also analysed the incidence of generalized adverse effect. There was no serious complication, however, 11.9% of the patients who underwent cerebral angiography with ioxaglate developed urticaria and this was significantly higher incidence than in the other two CM groups.