Low-osmolality contrast media-induced ventricular fibrillation

Area of Science:

• Cardiology
• Radiology
• Toxicology

Background:

• Low-osmolality contrast media (LOCM) are widely used in medical imaging.
• The arrhythmogenic potential of LOCM, particularly ventricular fibrillation, requires thorough investigation.
• Understanding the factors influencing contrast-induced arrhythmias is crucial for patient safety.

Purpose of the Study:

• To evaluate the incidence of ventricular fibrillation induced by various low-osmolality contrast media.
• To determine the role of sodium ions in the arrhythmogenic properties of contrast agents.

Main Methods:

• Right coronary arteriography was performed in eleven adult mongrel dogs.
• Test solutions of mannitol, ioxaglate, iopamidol, iotrolan, and sodium iopamidol were infused.
• Infusion continued until ventricular fibrillation occurred or for a maximum of 25 seconds (11 mL).

Main Results:

• Iotrolan induced 0% ventricular fibrillation.
• Sodium iopamidol and ioxaglate showed incidences of 8.3% and 10%, respectively.
• Iopamidol and mannitol resulted in 100% ventricular fibrillation, highlighting the arrhythmogenic potential of sodium-containing agents.

Conclusions:

• The absence of sodium ions appears to be a critical factor in preventing contrast-induced ventricular fibrillation.
• Iotrolan exhibited the least arrhythmogenic properties, potentially due to its low sodium content (8 mEq/L).
• These findings underscore the importance of contrast media composition in mitigating cardiac adverse events.