Electrocardiographic response to selective coronary arteriography.

Coskey, Richard L.; Magidson, Oscar

doi:10.1136/hrt.29.4.512

Cited by 51 publications

(21 citation statements)

References 7 publications

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“…1966, COSKEY & MAGIDSON 1967, GRENDAHL et coli. 1972 and may reflect effects on the impulse formation and conduction system, repolarization as well as myocardial oxygenation.…”

Section: Discussionmentioning

confidence: 98%

Tolerability and Usefulness of Iohexol in Cardioangiography

Levorstad¹,

Simonsen²,

Skrede³

et al. 1982

Acta Radiologica. Diagnosis

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“…1966, COSKEY & MAGIDSON 1967, GRENDAHL et coli. 1972 and may reflect effects on the impulse formation and conduction system, repolarization as well as myocardial oxygenation.…”

Section: Discussionmentioning

confidence: 98%

Tolerability and Usefulness of Iohexol in Cardioangiography

Levorstad¹,

Simonsen²,

Skrede³

et al. 1982

Acta Radiologica. Diagnosis

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“…The ECG follows a characteristic pattern. The ll1ean QRS vector shifts to the left during left, and to the right during right coronary angiography, while the mean T vector shifts in the Opposite direction (2,3,7). In patients with complete coronary artery occlusions small ECG changes are observed (7).…”

mentioning

confidence: 96%

“…l)uring left heart angiography small and transient ECG changes are usually seen (2). During selective Coronary angiography, however, marked changes in the QRS and T waves are generally observed.…”

mentioning

confidence: 99%

Electrocardiographic Changes During Selective Coronary Angiography

Grendahl¹,

Eie²,

Nordvik³

et al. 1972

Journal of Internal Medicine

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During selective coronary angiography ECG was recorded in leads 1 and II in 95 consecutive patients with the purpose of studying the ECG changes invoked by the injection of 7 ml Urografin 60% (Schering). Marked but transient changes were seen, probably caused by the physico‐chemical properties of the contrast medium. The selective injection of the same volume of Ringer solution did not evoke any ECG changes. When a blood volume in the coronary circulation is replaced by contrast medium or Ringer solution, transient coronary hypoxia will result. This hypoxia, therefore, is not the cause of the ECG changes observed in coronary angiography. Selective coronary angiography appears to impair depolarization as well as repolarization, the latter being the most affected function. Absence of ECG response during coronary injections indicates severe coronary artery disease or the presence of a single coronary artery. Right coronary injection is followed by an increase in PQ interval; arrhythmias seldom occur but are more likely to appear during right than during left coronary injections. The changes observed in this series are increased QRS and QT duration, a shift in QRS axis in the frontal plane, which is clockwise during right and counter‐clockwise during left coronary injections. The QRS vector is doubled. The T axis rotates in the frontal plane towards + 120° during left and towards – 75° during right coronary injection. When the T axis has this direction before angiography, no shift in axis is seen during injection of contrast medium.

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“…Contrast media‐induced ventricular tachyarrhythmias have been reported as one of the most serious side effects during coronary angiography [1]. Besides these very rare life‐threatening complications, transient prolongations of the QT intervals may be observed, especially when using high‐osmolality ionic contrast media [2]. Animal experiments have suggested that contrast media may produce regional prolongation of ventricular repolarization and increase myocardium vulnerability to ventricular fibrillation by increasing temporal dispersion of repolarization [3,4].…”

mentioning

confidence: 99%

Torsade de pointes induced by ioxaglate intracoronary injection in patients with pre‐existent drug‐induced QT prolongation: case reports and review of literature

Andréjak

Leborgne

Tribouilloy

et al. 2011

Fundamemntal Clinical Pharma

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We report two cases of torsade de pointes directly related to intracoronary contrast media injection in patients without previous history of neither arrhythmia nor syncope but chronically treated with a drug prolonging ventricular repolarization. We discussed the effects of the contrast medium used on repolarization and concluded that three suggestions may be highlighted from the case reports presented and from the literature: (i) a QT prolongation should be systematically searched before coronary angiography; (ii) it seems important to correct QT prolongation when it results from a reversible cause (such as drug-induced) before nonurgent coronary angiography; and (iii) if there is no reversible cause explaining QT prolongation, contrast media should be used cautiously in such patient and nonionic iso-osmolar contrast media should be preferred.

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Electrocardiographic response to selective coronary arteriography.

Cited by 51 publications

References 7 publications

Tolerability and Usefulness of Iohexol in Cardioangiography

Tolerability and Usefulness of Iohexol in Cardioangiography

Electrocardiographic Changes During Selective Coronary Angiography

Torsade de pointes induced by ioxaglate intracoronary injection in patients with pre‐existent drug‐induced QT prolongation: case reports and review of literature

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