Clinical significance and predisposing factors to symptomatic bradycardia and hypotension after percutaneous transluminal coronary angioplasty.
Of 180 consecutive patients who underwent uneventful percutaneous transluminal coronary angioplasty (PTCA), 25 (13.9%) had at least 1 episode of symptomatic bradycardia and hypotension during the early postprocedure period. Symptomatic bradycardia and hypotension occurred 1 to 10 hours (mean 4 +/- 2) after PTCA. A higher incidence of symptomatic bradycardia and hypotension was found in patients receiving regular treatment with beta blockers (26% vs 10% in patients without beta blockers in their regimen, p < 0.01), diltiazem or verapamil (20% vs 9%, p < 0.025), or both a beta blocker and diltiazem or verapamil (64% vs 11%, p < 0.001). A higher incidence was also associated with angioplasty of the left anterior descending coronary artery compared with angioplasty of the other coronary arteries (22% vs 8%, p < 0.01). It is concluded that symptomatic bradycardia and hypotension is a common occurrence after PTCA. The incidence is higher after PTCA to the left anterior descending coronary artery and in patients receiving diltiazem, verapamil, and beta-blocking agents; it is particularly high in patients receiving a combination of a beta-blocking agent and either diltiazem or verapamil.
Department of Cardiology, Beilinson Medical Center, Petah Tikva, Israel.
A
A
Mager
B
B
Strasberg
E
E
Rechavia
Y
Y
Birnbaum
A
A
Mazur
N
N
Yativ
S
S
Sclarovsky
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001919:Bradycardia / Q000139:chemically induced / Q000209:etiology*; D003327:Coronary Disease / Q000188:drug therapy / Q000628:therapy*; D004110:Diltiazem / Q000009:adverse effects; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014700:Verapamil / Q000009:adverse effects
D000319:Adrenergic beta-Antagonists; D014700:Verapamil; D004110:Diltiazem