Reducing arrhythmogenic effects in the isolated heart by enriching roentgen contrast media with electrolytes - Survey and present state

A review of the literature on the effects of adding electrolytes to ionic as well as nonionic contrast media (CM) in the isolated heart model reveals that both ionic and nonionic CM favor from such addition, if the addded electrolytes are balanced with respect to each other. By enriching nonionic monomeric as well as dimeric CM with such a balanced electrolyte solution, the risk of ventricular fibrillation is reduced and myocardial contractility is improved compared to nonionic CM without such enrichment. The new nonionic dimer iodixanol is slightly hypotonic to plasma in concentrations suitable for coronary arteriography. The water solution of iodixanol therefore contains an osmotic space in which electrolytes can be added, thereby making it isotonic with plasma.