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Title: The Frequency and Significance of Silent Myocardial Ischemia Due to Hyoscine Butylbromide Use in Peripheral Angiography

Abstract

Purpose: Hyoscine-N-butylbromide (HB) is an anticholinergic drug used in digital subtraction angiography of the aortoiliac region because it decreases bowel gas movement artifact. HB also causes an increase in heart rate. We investigated whether this could cause silent myocardial ischemia (SMI) in susceptible patients during peripheral angiography. Methods: Thirty-six patients undergoing peripheral angiography were randomized into two groups, with 17 patients receiving 20 mg HB intraarterially during the angiogram and 19 patients receiving no drug. All patients were fitted with a Holter monitor that recorded the electrocardiogram before, during, and after the angiogram. Heart rate trends and ST segments were then analyzed. Results: Patients given HB had a statistically significant rise in heart rate compared with the control group. Although the difference was not statistically significant, two (12%) patients receiving HB had procedural ST depression compared with none in the control group. Pre- and postprocedural episodes of ST depression were common, occurring in 41% of patients receiving HB and 37% of patients receiving no drug, and were associated with an increase in heart rate. Conclusion: The infrequent episodes of procedural SMI, potentially caused by the positive chronotropic effects of HB, are probably insignificant when compared with the high frequency ofmore » SMI episodes occurring outside the procedure.« less

Authors:
;  [1];  [2];  [1]
  1. Department of Radiology, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU (United Kingdom)
  2. Department of Cardiology, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU (United Kingdom)
Publication Date:
OSTI Identifier:
21080278
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 22; Journal Issue: 5; Other Information: DOI: 10.1007/s002709900409; Copyright (c) 1999 Springer-Verlag New York Inc; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; BLOOD VESSELS; DRUGS; ELECTROCARDIOGRAMS; HEART; ISCHEMIA; PATIENTS

Citation Formats

Maher, Richard, Phillips-Hughes, Jane, Banning, Adrian, and Boardman, Philip. The Frequency and Significance of Silent Myocardial Ischemia Due to Hyoscine Butylbromide Use in Peripheral Angiography. United States: N. p., 1999. Web. doi:10.1007/S002709900409.
Maher, Richard, Phillips-Hughes, Jane, Banning, Adrian, & Boardman, Philip. The Frequency and Significance of Silent Myocardial Ischemia Due to Hyoscine Butylbromide Use in Peripheral Angiography. United States. doi:10.1007/S002709900409.
Maher, Richard, Phillips-Hughes, Jane, Banning, Adrian, and Boardman, Philip. Wed . "The Frequency and Significance of Silent Myocardial Ischemia Due to Hyoscine Butylbromide Use in Peripheral Angiography". United States. doi:10.1007/S002709900409.
@article{osti_21080278,
title = {The Frequency and Significance of Silent Myocardial Ischemia Due to Hyoscine Butylbromide Use in Peripheral Angiography},
author = {Maher, Richard and Phillips-Hughes, Jane and Banning, Adrian and Boardman, Philip},
abstractNote = {Purpose: Hyoscine-N-butylbromide (HB) is an anticholinergic drug used in digital subtraction angiography of the aortoiliac region because it decreases bowel gas movement artifact. HB also causes an increase in heart rate. We investigated whether this could cause silent myocardial ischemia (SMI) in susceptible patients during peripheral angiography. Methods: Thirty-six patients undergoing peripheral angiography were randomized into two groups, with 17 patients receiving 20 mg HB intraarterially during the angiogram and 19 patients receiving no drug. All patients were fitted with a Holter monitor that recorded the electrocardiogram before, during, and after the angiogram. Heart rate trends and ST segments were then analyzed. Results: Patients given HB had a statistically significant rise in heart rate compared with the control group. Although the difference was not statistically significant, two (12%) patients receiving HB had procedural ST depression compared with none in the control group. Pre- and postprocedural episodes of ST depression were common, occurring in 41% of patients receiving HB and 37% of patients receiving no drug, and were associated with an increase in heart rate. Conclusion: The infrequent episodes of procedural SMI, potentially caused by the positive chronotropic effects of HB, are probably insignificant when compared with the high frequency of SMI episodes occurring outside the procedure.},
doi = {10.1007/S002709900409},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 5,
volume = 22,
place = {United States},
year = {1999},
month = {9}
}