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Incidence of ventricular fibrillation during left coronary arteriography in pigs: comparison of a solution of the nonionic dimer iodixanol with solutions of five different nonionic monomers.

Chai, Chun-Ming LU ; Karlsson, J O G and Almén, Torsten LU (2008) In Acta radiologica (Stockholm, Sweden : 1987) 49(2). p.150-156
Abstract
BACKGROUND: Solutions of iodine contrast media (CM) used for selective coronary arteriography (CA) should have minimal propensity to cause ventricular fibrillation (VF). Commonly used CM for CA are nonionic monomers or dimers. PURPOSE: To compare VF propensity of ready-to-use solutions of one nonionic dimer, iodixanol, and five nonionic monomers, iobitridol, iopamidol, iomeprol, iopromide, and ioversol. MATERIAL AND METHODS: Twenty milliliters of each CM was injected into the left coronary artery (LCA) through an inflated balloon catheter (0.5 ml/s) in 14 pigs; the longest period of injection was 40 s. If VF occurred before 40 s, the injection was stopped and the heart was defibrillated. After VF, there was a delay of 40 min before the... (More)
BACKGROUND: Solutions of iodine contrast media (CM) used for selective coronary arteriography (CA) should have minimal propensity to cause ventricular fibrillation (VF). Commonly used CM for CA are nonionic monomers or dimers. PURPOSE: To compare VF propensity of ready-to-use solutions of one nonionic dimer, iodixanol, and five nonionic monomers, iobitridol, iopamidol, iomeprol, iopromide, and ioversol. MATERIAL AND METHODS: Twenty milliliters of each CM was injected into the left coronary artery (LCA) through an inflated balloon catheter (0.5 ml/s) in 14 pigs; the longest period of injection was 40 s. If VF occurred before 40 s, the injection was stopped and the heart was defibrillated. After VF, there was a delay of 40 min before the next injection. Hemodynamic parameters and vector electrocardiography (VECG) were monitored. A CM with a lower frequency of VF and a longer period between start of injection and start of VF was considered to have a lower VF propensity. RESULTS: Following 14 injections, each of the five nonionic monomers caused 14 VF, whereas iodixanol caused three VF (P<0.01). When VF occurred after iodixanol, it occurred later than after the other CM (P<0.001). Iodixanol caused less prolongation in QRS time (P<0.01) and QTc time (P<0.05) than the other CM. Prolongations in QRS and QTc times caused by CM parallel the VF propensities of the CM. CONCLUSION: Ready-to-use solutions of the dimer iodixanol have lower VF propensity than solutions of the five monomeric CM. This is related to the fact that the solutions of the dimer iodixanol have lower osmolality, higher viscosity, and higher concentrations of NaCl and CaCl2 than solutions of the five monomers. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta radiologica (Stockholm, Sweden : 1987)
volume
49
issue
2
pages
150 - 156
publisher
John Wiley & Sons
external identifiers
  • PMID:18300138
  • WOS:000253642300006
  • Scopus:40049097128
ISSN
1600-0455
DOI
10.1080/02841850701675693
language
English
LU publication?
yes
id
51d3b8c0-02bf-427e-b2d2-b88ff676fc8f (old id 1041510)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18300138?dopt=Abstract
date added to LUP
2008-03-03 14:48:37
date last changed
2016-10-13 04:31:45
@misc{51d3b8c0-02bf-427e-b2d2-b88ff676fc8f,
  abstract     = {BACKGROUND: Solutions of iodine contrast media (CM) used for selective coronary arteriography (CA) should have minimal propensity to cause ventricular fibrillation (VF). Commonly used CM for CA are nonionic monomers or dimers. PURPOSE: To compare VF propensity of ready-to-use solutions of one nonionic dimer, iodixanol, and five nonionic monomers, iobitridol, iopamidol, iomeprol, iopromide, and ioversol. MATERIAL AND METHODS: Twenty milliliters of each CM was injected into the left coronary artery (LCA) through an inflated balloon catheter (0.5 ml/s) in 14 pigs; the longest period of injection was 40 s. If VF occurred before 40 s, the injection was stopped and the heart was defibrillated. After VF, there was a delay of 40 min before the next injection. Hemodynamic parameters and vector electrocardiography (VECG) were monitored. A CM with a lower frequency of VF and a longer period between start of injection and start of VF was considered to have a lower VF propensity. RESULTS: Following 14 injections, each of the five nonionic monomers caused 14 VF, whereas iodixanol caused three VF (P&lt;0.01). When VF occurred after iodixanol, it occurred later than after the other CM (P&lt;0.001). Iodixanol caused less prolongation in QRS time (P&lt;0.01) and QTc time (P&lt;0.05) than the other CM. Prolongations in QRS and QTc times caused by CM parallel the VF propensities of the CM. CONCLUSION: Ready-to-use solutions of the dimer iodixanol have lower VF propensity than solutions of the five monomeric CM. This is related to the fact that the solutions of the dimer iodixanol have lower osmolality, higher viscosity, and higher concentrations of NaCl and CaCl2 than solutions of the five monomers.},
  author       = {Chai, Chun-Ming and Karlsson, J O G and Almén, Torsten},
  issn         = {1600-0455},
  language     = {eng},
  number       = {2},
  pages        = {150--156},
  publisher    = {ARRAY(0xae5f610)},
  series       = {Acta radiologica (Stockholm, Sweden : 1987)},
  title        = {Incidence of ventricular fibrillation during left coronary arteriography in pigs: comparison of a solution of the nonionic dimer iodixanol with solutions of five different nonionic monomers.},
  url          = {http://dx.doi.org/10.1080/02841850701675693},
  volume       = {49},
  year         = {2008},
}