Heart rate control in paediatric coronary CT angiography using phenylephrine.

AIMS: Obtaining images of diagnostic quality using coronary CT angiography (CCTA) depends, in part, upon a patient's heart rate (HR) at time of scanning. HR reduction is most commonly achieved with beta blockers. In the paediatric population, the effectiveness of beta blockers is limited by hypotensive effects. Phenylephrine, a pure alpha agonist, raises blood pressure and causes reflex bradycardia so it could be used to reduce patients' HRs.

METHODS AND

RESULTS

We retrospectively reviewed all children at a single centre who underwent sedated CCTA study using phenylephrine between 2019 and 2024. In 25 children (mean age 5.3 ± 2.5 years), HR was reduced from a mean of 94.1 to 73.8 beats per minute (bpm). No adverse effects were reported. Images of diagnostic quality were obtained in all patients.

CONCLUSION

In this first-of-its-kind study we found that phenylephrine was effective at reducing patients' HRs prior to CCTA, with an average reduction of 20 bpm.