Arrhythmias occurring during intravenous urography

A low but significant fatality rate persists in intravenous urography. Fatalities are sudden and their cause is not understood. This trial assessed the arrhythmogenic effects of a common urographic contrast agent. Using standard bolus injection techniques, 12 patients out of 58 (20%) developed post-injection arrhythmias. Seven of these cases (12%) were considered to have significant or potentially serious arrhythmias. This group includes various paroxysmal tachycardias and a case of atrioventricular block. Arrhythmia post-injection was commoner in the male and in the older age groups. An abnormal control ECG was not found to be a predisposing factor to the development of arrhythmia. It is suggested that the findings reflect the high incidence of latent coronary heart disease in our older male population. No correlation was found with minor side-effects of contrast injection and the development of arrhythmia.