Electrocardiographic response to intravenous urography: prospective evaluation of 275 patients

Ventricular tachycardia precipitated by sodium iothalamate (Conray 420) injection during prenylamine treatment: a predictable adverse drug interaction

“…The observation relevant to the present case was that bolus injection of sodium iothalamate prolonged the QT, by a mean of 0.07 s, with the prolongation exceeding 0.1 s in about one third of patients (Stadalnik et al, 1977). The authors believe that this patient was predisposed to ventricular tachycardia by the added effect of sodium iothalamate on the QTc, which was already markedly prolonged by prenylamine, and that the arrhythmia was precipitated by a ventricular extrasystole occurring during the prolonged QTc.…”

“…The causes of these deaths are uncertain and there was no record of electrocardiogram (ECG) monitoring. Various ECG abnormalities have been recorded during intravenous urography, including an increase in heart rate, ST segment depression, atrial and ventricular extrasystoles and QTc prolongation (Berg et al, 1973;Small & Glenn, 1968;Stadalnik et al, 1974;Stadalnik et al, 1977;Pfister & Hutter, 1980;Lawton et al, 1982).…”

“…Other contrast media may also prolong the QT, and present a similar hazard (Stadalnik et al, 1977). The risk might be reduced by administering the contrast medium by infusion rather than as a bolus injection as the former has less effect on the QTc.…”

“…The authors are aware of only three reports of documented ventricular tachycardia occurring during intravenous urography (Stadalnik et al, 1974;Stadalnik et al, 1977). One of these patients was taking procainamide and had a prolonged QTc of 0.52 s and another was taking quinidine.…”

Die Problematik der Kontrastmittelüberempfindlichkeit

“…Im großen und ganzen ähnliche Zahlen finden sich bei den anderen in Tabelle 2 aufgeführten Autoren (1, 9,11,13,16,18,24,38,42,44,45,51,55,57,62,64,65,66 Herzrhythmusstörungen sind keineswegs selten, insbesondere nach Koronarangiographie (64). Sie können sich als Sinustachykardie (58), Bradykardie (22) oder Extrasystolen manifestieren (58,59) Urographie (57) Mediatorsubstanzen hervorgerufen werden, wie im folgenden diskutiert werden wird. Bekannt ist der urikosurische Effekt von Röntgenkon-trastmitteln.…”