Why are the benefits of beta-blocker administration prior to coronary computed tomography angiography (CCTA)?

Updated: Dec 21, 2017
  • Author: Eugene C Lin, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Beta-blocker administration is often helpful in cardiac computed tomography (CT) to lower the heart rate and decrease motion artifact. The level to which the heart rate should be lowered depends on the temporal resolution of the scan. With single-source CT scanners, it is usually helpful to lower heart rate below 65 beats per minute (bpm), and ideally below 60 bpm. Dual-source CT scanners have higher temporal resolution and can be performed at heart rates of up to 90 bpm, obviating the need for beta blockers in many cases. Cardiac MRI has higher temporal resolution than CT and can be performed without beta blockers.

However, heart rate variability may be a more important determinant of image quality than absolute heart rate. [4] Beta blockers are also helpful in patients with irregular heart rates, supraventricular tachycardias, and arrhythmias. For example, in atrial fibrillation, the negative chronotropic and dromotropic effects can lengthen diastole. [60]


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