Related Experiment Video

Updated: Jun 27, 2026

High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals
11:09

High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals

Published on: December 16, 2022

Safety and efficacy of a rate control protocol for cardiac CT

W T Roberts1, A R Wright, J B Timmis

  • 1The Hospital of St John and St Elizabeth, 60 Grove End Road, St John's Wood, London NW8 9NH, UK. dwstret02@sneakemail.com

The British Journal of Radiology
|December 23, 2008
PubMed

Insights

A new protocol using oral metoprolol effectively controls heart rate for cardiac CT angiography (CTCA). This improves scan quality and reduces motion artifacts in most patients undergoing CTCA.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Pharmacology

Background:

  • Clinical use of cardiac CT is growing.
  • Motion artifacts due to elevated heart rate can compromise CT coronary angiography (CTCA) image quality.
  • Heart rate control is often necessary for diagnostic CTCA.

Purpose of the Study:

  • To describe and evaluate a protocol for heart rate control in patients undergoing outpatient CTCA.
  • To assess the efficacy and safety of oral metoprolol and verapamil for heart rate reduction prior to CTCA.
  • To correlate heart rate control with CTCA image quality.

Main Methods:

  • A protocol involving oral metoprolol (100 mg) or verapamil (240 mg) 60 minutes before CTCA was implemented.
  • Intravenous boluses were administered if heart rate remained above 60 bpm.
  • Heart rates and image quality (motion artifact grading) were assessed.
  • Adverse events were recorded.

Main Results:

  • 75% of patients required rate control medication.
  • Oral metoprolol achieved heart rates ≤65 bpm in 83% and ≤60 bpm in 65% of patients.
  • Verapamil showed poor efficacy, with all patients >70 bpm.
  • Severe motion artifact (Grade 3) was significantly lower in patients with heart rates ≤60 bpm (0.9%) compared to those >70 bpm (50%).
  • No adverse events were reported from the medications.

Conclusions:

  • Oral metoprolol administration according to the described protocol is safe and effective for reducing heart rate in most patients undergoing CTCA.
  • Effective heart rate control significantly improves CTCA image quality by reducing motion artifacts.
  • The protocol offers a reliable strategy for optimizing CTCA studies.

More Related Videos

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Related Concept Videos

Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...