Diltiazem for Reducing Heart Rate in Orthotopic Heart Transplant Patients During Coronary Computed Tomography Angiography

• Published in: Journal of radiology nursing Vol. 41; no. 1; pp. 33 - 37
• Main Authors: Somers, Andrew, Allen, Deborah H., Cahill, Joan, Molvin, Lior, Stone, Brittney, Olivas, Alicia, Strazis, Caroline, Kramer, Amy
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-03-2022
• Subjects: Coronary CT angiography; Diltiazem; Orthotopic heart transplant; Coronary CT angiography; Diltiazem; Orthotopic heart transplant
• ISSN: 1546-0843
• DOI: 10.1016/j.jradnu.2021.11.004

This study sought to evaluate the effectiveness of diltiazem at achieving a targeted heart rate (HR) of ≤75 bpm in orthotopic heart transplant patients during coronary computed tomography (CT) angiography.
Baseline heart rates were compared to heart rates after diltiazem administration in 25 adult orthotopic heart transplant subjects being monitored by electrocardiogram (ECG) gaiting on a multidetector CT scanner.
The mean baseline HR of the group was 84.28 ± 11.305 bpm. After diltiazem administration, the mean heart rate of the group at the time of the coronary CT angiography study was 75.32 ± 9.49 bpm. Heart rates decreased in 23 subjects (92%) and the targeted heart rate of ≤75 bpm was observed in 13 subjects (52%).
Diltiazem administration was associated with a decrease in heart rate, yet reaching the targeted heart rate was limited. Further study regarding diltiazem dosing and its impact is warranted.
•Coronary CT angiography assists in the detection of CAV in heart transplant patients.•Diltiazem may positively impact the overall scan by decreasing cardiac motion artifact.•Diltiazem can provide a safe alternative to beta blockers if needed for CCTAs.