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Randomized controlled trial of relaxation music to reduce heart rate in patients undergoing cardiac CT

  • Cardiac
  • Published:
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Abstract

Objectives

To evaluate the heart rate lowering effect of relaxation music in patients undergoing coronary CT angiography (CCTA), pulmonary vein CT (PVCT) and coronary calcium score CT (CCS).

Methods

Patients were randomised to a control group (i.e. standard of care protocol) or to a relaxation music group (ie. standard of care protocol with music). The groups were compared for heart rate, radiation dose, image quality and dose of IV metoprolol. Both groups completed State-Trait Anxiety Inventory anxiety questionnaires to assess patient experience.

Results

One hundred and ninety-seven patients were recruited (61.9 % males); mean age 56y (19-86 y); 127 CCTA, 17 PVCT, 53 CCS. No significant difference in heart rate, radiation dose, image quality, metoprolol dose and anxiety scores. 86 % of patients enjoyed the music. 90 % of patients in the music group expressed a strong preference to have music for future examinations. The patient cohort demonstrated low anxiety levels prior to CT.

Conclusion

Relaxation music in CCTA, PVCT and CCS does not reduce heart rate or IV metoprolol use. Patients showed low levels of anxiety indicating that anxiolytics may not have a significant role in lowering heart rate. Music can be used in cardiac CT to improve patient experience.

Key Points

• Relaxation music does not reduce heart rate in cardiac CT

• Relaxation music does not reduce beta-blocker use in cardiac CT

• Relaxation music has no effect on cardiac CT image quality

• Low levels of anxiety are present in patients prior to cardiac CT

• Patients enjoyed the relaxation music and this results in improved patient experience

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Abbreviations

CCS:

Coronary calcium score computed tomography

CCTA:

Coronary computed tomography angiography

CT:

Computed tomography

DLP:

Dose length product

DTA:

Descending thoracic aorta

EW:

Exposure window

HR:

Heart rate

HRB :

Heart rate during final breathhold during ECG calibration

HRI :

Heart rate during image acquisition

HRI-W :

The change in heart rate between HRI and HRW

HRT :

Heart rate on first arrival at the CT table

HRW :

Heart rate in the waiting room prior to randomisation

HU:

Hounsfield units

kV:

Kilovoltage

mA:

Milliampere

MDCT:

Multidetector computed tomography

PVCT:

Pulmonary vein computed tomography

RRI:

ECG R-R interval

STAI:

State-trait anxiety inventory

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Acknowledgments

The scientific guarantor of this publication is Elsie Thao Nguyen. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by a Peter Munk Cardiac Centre Innovation Grant. Dr Ravi Menezes kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, randomised controlled trial, performed at one institution.

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Authors and Affiliations

  1. Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, ON, Canada

    Ming Yen Ng, Yasser Karimzad, Ravi J. Menezes, Bernd J. Wintersperger, Qin Li, Julian Forero, Narinder S. Paul & Elsie T. Nguyen

  2. Department of Diagnostic Radiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong

    Ming Yen Ng

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  1. Ming Yen Ng
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  2. Yasser Karimzad
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  4. Bernd J. Wintersperger
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Correspondence to Ming Yen Ng.

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Ng, M.Y., Karimzad, Y., Menezes, R.J. et al. Randomized controlled trial of relaxation music to reduce heart rate in patients undergoing cardiac CT. Eur Radiol 26, 3635–3642 (2016). https://doi.org/10.1007/s00330-016-4215-8

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  • DOI: https://doi.org/10.1007/s00330-016-4215-8

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