Heart Rate Controller in Computed Tomography Coronary Angiography

Launched by MAHIDOL UNIVERSITY · Feb 28, 2022

Keywords

ClinConnect Summary

Coronary computed tomography angiography (CCTA) is one of important non-invasive test for diagnosis coronary artery disease. Information of CCTA can provide information such as coronary artery lumen, vessel wall, degree of stenosis and component of coronary arterial plaque. Most of studies in CCTA represent high negative predictive value (NPV) approximately 93-100 %.However, motion artifact has impact on CCTA interpretation, especially when heart rate (HR) at more than 70 beat-per-minute (bpm). Therefore, HR reduction maneuver is necessary for CCTA. Current recommendation suggests HR reduct...

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Eligibility criteria

• Inclusion Criteria:
• • 1. Age of at least 18 year-old
• • 2. Received Coronary CT angiography at Siriraj Hospital to evaluate diagnosis of coronary artery disease or risk stratification of coronary artery disease
• • 3. Normal sinus rhythm with baseline HR \> 60 bpm which cardiac imaging specialist suggest using HR lowering intervention
• Exclusion Criteria:
• • 1. Atrial fibrillation
• • 2. Previous pacemaker implantation
• • 3. II- and III-degree atrio-ventricular-block
• • 4. NHYA class III - IV
• • 5. Documented LVEF \< 40%
• • 6. Contraindication for CCTA: Impaired renal function (serum creatinine \> 1.5 mg/dl), known allergy to iodinated contrast media, pregnancy, thyroid disease
• • 7. Blood pressure \< 100/70 mmHg
• • 8. Uncontrolled asthma and/or chronic obstructive pulmonary disease (defined as GOLD stage D) and/or uncontrolled reactive airway disease
• • 9. Current medication which cause severe interaction with calcium channel blocker, beta blocker and/or Ivabradine
• • 10. Known allergy to calcium channel blocker, beta blocker and/or Ivabradine