PhD Scientific Days 2026

Cardiovascular Medicine and Research 3.

The Role of Beta Blocker Premedication Prior to Coronary CT Angiography in Atrial Fibrillation

Name of the presenter

Maraczi, Daniel

Institute/workplace of the presenter

Semmelweis University, Heart and Vascular Centre

Authors

Maráczi Dániel¹, Szabó Soma Levente¹, Jermendy Ádám Levente¹, Szilveszter Bálint¹, Bérczi Ákos¹, Bartykowszki Andrea¹, Panajotu Alexisz¹, Vida Adorján¹, Szegedi Nándor¹, Nagy Klaudia Vivien¹, Csobay-Novák Csaba¹, Maurovich-Horvat Pál², Gellér László¹, Merkely Béla¹, Drobni Zsófia Dóra¹
1: Semmelweis University, Heart and Vascular Centre
2: Semmelweis University, Medical Imaging Centre

Text of the abstract

Introduction: Coronary CT angiography (CCTA) is a reliable tool for coronary artery disease (CAD) assessment, but optimal image quality (IQ) requires a low and regular heart rate (HR). The effectiveness of beta blocker (BB) premedication in reducing HR and improving IQ is well established in sinus rhythm; however, data in atrial fibrillation (AF) remain limited.
Aims: This study aimed to evaluate whether BB premedication prior to CCTA decreases HR and improves IQ without a concomitant reduction in blood pressure values.
Method: This study identified patients who underwent CCTA in AF (2013-2025) and received nitrate premedication (n=1168). Scans were performed on three CT systems. IQ was graded using a four-point Likert scale (excellent, good, moderate, non-diagnostic), with excellent, good and moderate classified as diagnostic. HR and BP values were recorded at admission, pre-scan, post-scan and discharge. Patients were grouped by BB premedication. Statistical analysis was performed in RStudio using Fisher’s exact, chi-square, and Mann–Whitney U tests, as well as univariable and multivariable logistic regression; p<0.05 was considered significant.
Results: In the total cohort of 1168 patients (age: 63.7±11.1 years, 33% female) IQ was rated excellent in 8.6%, good in 36%, moderate in 41% (diagnostic in 85%) and non-diagnostic in 15%. BB premedication was administered in 31%. In the BB group, compared to the non-BB group, HR reduction from admission to pre-scan was larger (5 [0–12] vs 0 [-6–6], p<0.001), while the reduction in BP was not, and the proportion of diagnostic IQ was higher (90% vs. 83%, p=0.002). BB premedication, however, was not independently associated with diagnostic IQ in multivariable analysis.
Conclusion: BB premedication in AF reduces heart rate without a concomitant decrease in blood pressure; however, its independent effect on diagnostic IQ appears limited. Observed improvements may reflect overall scan optimization rather than BB administration itself. A prospective study is underway to further evaluate the role of beta blocker premedication in AF patients scanned with contemporary CT systems.
Funding: This study received no funding.