Isolation of Sodium as a Cause of Ventricular Fibrillation

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Abstract
A recent upturn in the frequency of ventricular fibrillation following selective coronary arteriography has promoted renewed investigation of contrast agents. A review of cases of marked cardiac arrhythmia during the procedure indicated that a decrease in sodium content in a commonly-used agent (Renografin 76%) was probably a causative factor. The present study was designed to isolate sodium content of a contrast agent as a major factor in ventricular fibrillation. A sodium-adjusted agent was obtained by dissolving sodium chloride crystals in the lower sodium agent (0.91 mg Na/ml) to raise the sodium level to that of the higher sodium agent (4.5 mg Na/ml). Thirty-two dog trials were performed with the three agents using randomized sequences. Only right coronary artery injections were made in this study, since the authors' previous work showed that the canine right coronary artery was much more sensitive to selective injection than the left. Ventricular fibrillation was significantly more frequent using the lower sodium agent than with the sodium-adjusted agent. No evident difference was noted between the sodium-adjusted and higher sodium agents.

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