Abstract
Results: Of the 1104 patients prepared for CTCA, 35 patients (3%) did not proceed due to inadequate heart rate control. The analysis excluded 108 patients on regular beta-blocker and 16 patients who had calcium channel blocker for heart rate control. Protocol adjustments occurred in half the patients, with a lowered Metoprolol dose given in 388 patients (41%). Subsequent IV Metoprolol is more frequent, compared to those given the suggested dosage. (41% vs. 30%, p= 0.0074) Safety is excellent, with rare complications: mild dizziness (1%), hypotension (2%, only one case was symptomatic). Conclusion: Safe pre-CTCA beta-blockade relies heavily on sound clinical judgment of experienced nurse specialists in adjusting the protocol-suggested dosage according to clinical status, but can be achieved without intensive medical supervision. http://dx.doi.org/10.1016/j.hlc.2013.04.103
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