Cardiovasc Imaging Asia.  2022 Jan;6(1):16-18. 10.22468/cvia.2021.00367.

Recurrent Paroxysmal Atrial Tachycardia Triggered by Deep Inspiration During Contrast Enhanced Computed Tomography Coronary Angiography

• Yew MS
• Tan KWK

• KMID: 2525207
• DOI: http://doi.org/10.22468/cvia.2021.00367

Abstract

A 64-year-old lady underwent CT coronary angiography. Rhythm tracing showed initial sinus bradycardia with sudden onset of atrial tachycardia (AT) during contrast administration and breath-holding, which resolved almost immediately after the scan. Motion artifacts were seen. This recurred during a repeat attempt, but self-terminated before the images were acquired. We hypothesize that the AT may be contributed by both respiratory cycle-dependent AT and use of iodinated contrast. Although rare and not previously reported in the setting of cardiac CT, we demonstrated that respiratory cycle-dependent AT can be triggered by conditions universally present during coronary CT, namely the need for deep inspiration, breath holding and intravenous iodinated contrast. This poses a unique challenge for coronary CT imaging and greater awareness of this entity is needed amongst CT technologists and physicians.

Keyword

Multidetector computed tomography; Coronary angiography; Tachycardia; ectopic atrial; Breath holding; Contrast media