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Heart rate control in paediatric coronary CT angiography using phenylephrine.
Yosef A Cohen1,2, Luca Bremner3, Mrinali Shetty4
1Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, 622 West 168th Street PH 10-203, New York, NY 10032, USA.
European Heart Journal. Imaging Methods and Practice
|February 27, 2026
Summary
Phenylephrine effectively reduced heart rate (HR) in children undergoing coronary CT angiography (CCTA), enabling diagnostic image quality. This study found a significant HR decrease with no reported adverse effects in pediatric patients.
Area of Science:
- Cardiovascular imaging
- Pediatric radiology
Background:
- Diagnostic image quality in coronary CT angiography (CCTA) is influenced by patient heart rate (HR).
- Beta blockers, commonly used for HR reduction, have limited effectiveness and potential hypotensive effects in pediatric patients.
- Phenylephrine, an alpha agonist, may offer an alternative by inducing reflex bradycardia.
Purpose of the Study:
- To evaluate the efficacy and safety of phenylephrine for heart rate reduction in pediatric patients undergoing CCTA.
- To assess the impact of phenylephrine on achieving diagnostic image quality in CCTA studies.
Main Methods:
- Retrospective review of pediatric patients who underwent sedated CCTA with phenylephrine administration.
- Analysis of heart rate changes before and after phenylephrine administration.
- Assessment of image quality and reported adverse events.
Main Results:
- Phenylephrine administration resulted in a mean heart rate reduction from 94.1 to 73.8 beats per minute (bpm) in 25 pediatric patients.
- An average heart rate decrease of 20 bpm was observed.
- Diagnostic quality images were obtained in all patients, with no reported adverse effects.
Conclusions:
- Phenylephrine is an effective agent for reducing heart rate in pediatric patients prior to CCTA.
- This approach facilitates the acquisition of diagnostic quality CCTA images in children.
- Phenylephrine represents a safe and effective alternative for heart rate management in pediatric CCTA.
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