THE EFFECT OF METOPROLOL ALONE AND METOPROLOL PLUS BROMAZEPAM ON HEART RATE AND HEART RATE VARIABILITY DURING MULTISLICE COMPUTED TOMOGRAPHY ANGIOGRAPHY

Abstract

Objective: The purpose of this study was to determine the effect of metoprolol alone and metoprolol plus bromazepam on heart rate and heart rate variability during multi slice computed tomography (MSCT) angiography. Methodology: This was a Double blind randomized controlled trial was conducted at AFIC/NIHD, Rawalpindi, from May 2011 to November 2011. Patients undergoing first MSCT angiography meeting inclusion criteria with heart rates (HR) more than 80 beats/min were included. Patients were randomized in to two groups using random numbers table. Group 1 was administered metoprolol plus placebo while group 2 was administered metoprolol plus bromazepam one hour before the scan. Both groups had scans under strictly similar conditions. HR before and during scan along with heart rate variability (HRV) were recorded. Results: A total of 80 patients were included. Patients mean age was 49 + 13, 57 % were males while 43 % were females. Risk factor profile was similar in both groups. HR reduction in group 1 was 15+ 6.0 and in group 2, was 21+9.0 (p= 0.002). HRV in group 1 was 3.9+ 1.32 and in group 2 was 2.3+1.0 (p= 0.003). Group 2 had significantly lower HR and significantly less HRV as compared with group 1. Conclusion: Combination of bromazepam and metoprolol results in significant and further reduction in heart rate and heart rate variability than metoprolol alone. Both drugs can be used together for a better control of heart rate and heart rate variability during MSCT angiography for improving the quality of images.