Role of sodium addition to nonionic contrast medium in preventing ventricular fibrillation during coronary arteriography in dogs.
OBJECTIVE
We studied the effect of the addition of sodium to nonionic contrast medium (CM) on the incidence of ventricular fibrillation (VF) during coronary arteriography in dogs.


METHODS
We infused 20 ml (0.5 ml/sec) of iohexol, iohexol plus 30 mmol of Na+ per liter, and NaCl-Ringer's acetate in randomized order through a wedged catheter placed in the right coronary artery (RCA) or in the left anterior descending coronary artery (LAD) in 12 anesthetized dogs. In addition to electrocardiographic and hemodynamic measurements, epicardial monophasic action potential durations and ventricular activation times were recorded during infusions into the LAD.


RESULTS
All infusions with iohexol into the RCA and the LAD (n = 16) caused VF. Seven of 19 infusions with iohexol plus 30 mmol of Na+ per liter caused VF. Infusions with iohexol plus 30 mmol of Na+ per liter that did not cause VF lengthened monophasic action potential durations and increased ventricular activation times more in the CM-perfused area than in the control area.


CONCLUSIONS
The addition of sodium to iohexol reduces the incidence of VF when infused through a wedged catheter. The protective mechanisms may be attributable to a lengthened repolarization phase and an increased activation time in the CM-perfused area.
Jacobsen
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EA
Department of Radiology, University of Tromsø, Norway.
Kløw
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NE
Refsum
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H
D000200:Action Potentials / Q000187:drug effects; D000704:Analysis of Variance; D000818:Animals; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D017023:Coronary Angiography / Q000379:methods* / Q000706:statistics & numerical data; D003331:Coronary Vessels / Q000187:drug effects / Q000502:physiology; D004285:Dogs; D004562:Electrocardiography / Q000187:drug effects / Q000706:statistics & numerical data; D005260:Female; D015994:Incidence; D007261:Infusions, Intra-Arterial; D007472:Iohexol / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D011897:Random Allocation; D012965:Sodium Chloride / Q000008:administration & dosage*; D014693:Ventricular Fibrillation / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*
D003287:Contrast Media; D007472:Iohexol; D012965:Sodium Chloride