Background
In light of the COVID-19 pandemic, in 2020 we sought to minimise patient preparation time for CT coronary angiography (CTCA) by not administering beta-blockers.
Methods
Records were reviewed of consecutive patients undergoing CTCA at two sites with 3rd generation dual-source scanners between March and November 2020. No beta-blockers or other rate-control medications were administered on site. Axial end-systolic, mid-diastolic or high-pitch spiral (TURBOFLASH) scan modes were chosen dependent on heart rate. Patient preparation times were compared with a subset of consecutive patients in 2019.
Results
1,000 patients were identified with a mean age of 63 years. 52.9% of initial scans were acquired in end-systole, while 32.1% were acquired in diastole with an axial scan mode, and 15% with a spiral high-pitch scan in diastole. Diagnostic image quality in all coronary segments was achieved in 999 patients (99.9%). The time from patient registration to scan completion at one site was a median of 59 (48-75) minutes in 2020 (n=106), compared to 85 (64-83) minutes in 2019 (n=99), p<0.001. At the second site, the staff-exposure time measured from the start of patient preparation to the start of image acquisition was 19 minutes (14-29) in 2020 (n=360). 28.3% of patients were on regular rate-control medications and 17.0% had documented atrial fibrillation.
Conclusions
High quality diagnostic CTCA can be reliably performed without administration of beta-blockers. This protocol for streamlined CTCA minimised patient contact time during the COVID-19 pandemic.
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