Alteration of ventricular repolarization by intracoronary infusion of normal saline in patients with variant angina.
OBJECTIVE
During coronary angiography and interventional procedures, catheters that are engaged in a coronary ostium are routinely flushed, typically with normal saline, to expel blood from the catheter or to inject a pharmacologic agent. Saline contains sodium and chloride ions. Such injections may affect the electrophysiologic properties of the myocardium; however, the effect of normal saline on ventricular repolarization has not been established in patients with variant angina.


METHODS
We studied 51 consecutive patients with variant angina. Five mL of normal saline (NS) or 5% dextrose solution (DW) were infused into the left coronary artery in random order. We measured the heart rate, QT interval, and T-wave amplitude using Mac-Lac 5.2.


RESULTS
The baseline clinical characteristics were not different between the NS {n=30 (14 males); mean age, 56+/-10 years} and the 5% DW groups {n=21 (7 males); mean age, 59+/-10 years}. The changes in the mean corrected QT (QTc) interval were significantly increased at the time of infusion of NS compared to 5% DW (45.1+/-30.3 vs. 20.9+/-23.3 ms, p=0.004). There was a T-wave amplitude change >0.2 mV in at least one-lead in 27 patients (90.0%) during NS infusion compared to 7 patients (33.3%) during 5% DW infusions (p=0.001). No significant changes in heart rate and blood pressure were noted during of the infusions.


CONCLUSIONS
NS was associated with prolongation of ventricular repolarization in patients with variant angina.
Kim
Jae Kwon
JK
Cardiovascular Center, Wonkwang University Hospital, Iksan, Korea.
Kim
Nam-Ho
NH
Shin
Ik Sang
IS
Noh
Dong Hyo
DH
Kim
Yong Cheol
YC
Kim
Seung Hwan
SH
Choi
Jun Ho
JH
Park
Eun Mi
EM
Lee
Sang Jae
SJ
Yun
Kyeong Ho
KH
Yoo
Nam Jin
NJ
Lee
Eun Mi
EM
Oh
Seok Kyu
SK
Jeong
Jin-Won
JW