Amiodarone administered for cardiac resuscitation does not alter the integrity of noncontrast cerebral computed tomography performed on neurologically symptomatic patients before therapeutic cardiac catheterization.
OBJECTIVE
Recent revisions of the advanced cardiac life support guidelines support the use of amiodarone in treating acute cardiac arrhythmia. Chemically, amiodarone has two atoms of iodine per molecule (39.3% wt/wt). We propose that at antiarrhythmic doses as prescribed by advanced cardiac life support guidelines, enhancement resulting from the bound amiodarone iodine is not significantly different from routine noncontrasted screening cerebral computed tomography (CT) studies.


METHODS
Six patients presenting to the our emergency department with successful resuscitation after cardiac arrhythmia were identified before obtaining a screening CT scan and subsequent transfer to the cardiac catheterization laboratory for intervention. The total dose of amiodarone (bolus + drip) was calculated up to the moment of the CT scan. Subjects were age and gender matched with two control subjects. Hematocrit value and CT density measurements in the pons, putamen, centrum semiovale, and cerebral venous blood pool were recorded. Paired t test and linear regression analyses were performed. Amiodarone dose and hematocrit were used as covariates in the regression model to correct for altered density as a result of relative anemia.


RESULTS
Mean density in the blood pool was increased in the amiodarone subjects in both the univariate and regression models. Although the mean density difference of 3 HU was statistically significant, it is not likely detectable by the eye. All other brain area measurements showed nonsignificant differences in mean density for both the univariate analysis and regression model.


CONCLUSIONS
Amiodarone administered at doses recommended by the American Heart Association for treatment of cardiac arrhythmia does not interfere with interpretation of the precatheterization noncontrasted screening cerebral CT scan.
Ptak
Thomas
T
Division of Emergency Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. tptak@partners.org
Novelline
Robert A
RA
D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006328:Cardiac Catheterization; D016887:Cardiopulmonary Resuscitation; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone