DOI: 10.36347/sjams.2014.v02i01.0036

Pages: 171-175

Heart rate control is crucial for diagnostic accuracy and proper image quality of CTCA. A lower heart rate reduces coronary artery movement artifacts by increasing the length of diastolic phase, thereby improving image quality as blood stay longer in vessels. Despite wide spread use of β-blockers ,it has been difficult to achieve target heart rates in patients undergoing CTCA. Ivabradine is a novel purely negative chronotropic drug which acts on sinus node &decreases heart rate without significant hemodynamic effects or impairment of cardiac conduction. Our study assessed the efficacy of ivabradine on image quality of CT coronary angiography (CTCA) and compared it with β- blockers. We randomized 100 consecutive patients undergoing CTCA to receive either of the two premedication protocols: oral β-blockers or ivabradine. Images were scored in terms of image quality of the coronary artery segments using a 5-point grading scale. Ivabradine achieved better heart rate reduction & also required less additional pre study doses of rate controlling drugs. CTCA image quality with ivabradine group had 95% diagnostically accepted coronary segments imaging compared to 90% with the β – blocker group. β- blocker significantly lowered both systolic and diastolic blood pressure, while ivabradine did not. Ivabradine is an attractive alternate to β- blocker for reduction of heart rate in patients undergoing CTCA and had an excellent safety profile.