Richards K L, Browning J D, Hoekenga D E
Cathet Cardiovasc Diagn. 1981;7(2):185-90. doi: 10.1002/ccd.1810070208.
A double-blind study of 90 patients undergoing coronary angiography was performed to determine the safety and efficacy of 0.6 mg atropine sulfate in preventing contrast-induced bradycardia. Coronary angiography performed using the Sones technique resulted in ventricular pauses of greater than 2 seconds in 3 of 49 patients (6%) who received prophylactic atropine and 20 of 41 patients (49%) receiving placebo. Though the pauses were usually due to atrial asystole, 26% of those with greater than 2 second pauses did so because of transient complete heart block. Prophylactic atropine did increase resting heart rate but did not cause other arrhythmias or increase the frequency of angina pectoris despite the presence of severe coronary disease. Our data indicate that contrast-induced asystole is very common, cannot be predicted by consideration of "precatheterization data," and can be prevented effectively and safely by use of prophylactic atropine sulfate.
一项针对90例接受冠状动脉造影术患者的双盲研究，旨在确定0.6毫克硫酸阿托品预防造影剂诱发心动过缓的安全性和有效性。采用索内斯技术进行冠状动脉造影时，在接受预防性阿托品的49例患者中有3例（6%）出现大于2秒的心室停搏，而接受安慰剂的41例患者中有20例（49%）出现此类情况。虽然这些停搏通常是由于心房停搏，但在大于2秒停搏的患者中，有26%是由于短暂性完全性心脏传导阻滞所致。预防性阿托品确实会增加静息心率，但尽管存在严重冠状动脉疾病，却不会引发其他心律失常或增加心绞痛发作频率。我们的数据表明，造影剂诱发的心脏停搏非常常见，无法通过“导管插入术前数据”预测，并且使用预防性硫酸阿托品可有效且安全地预防。
