European Radiology

, Volume 26, Issue 10, pp 3635–3642 | Cite as

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

  • Ming Yen NgEmail author
  • Yasser Karimzad
  • Ravi J. Menezes
  • Bernd J. Wintersperger
  • Qin Li
  • Julian Forero
  • Narinder S. Paul
  • Elsie T. Nguyen



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).


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.


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.


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


Coronary computed tomography angiography Heart rate Calcium score Beta-blocker Pulmonary vein CT 



Coronary calcium score computed tomography


Coronary computed tomography angiography


Computed tomography


Dose length product


Descending thoracic aorta


Exposure window


Heart rate


Heart rate during final breathhold during ECG calibration


Heart rate during image acquisition


The change in heart rate between HRI and HRW


Heart rate on first arrival at the CT table


Heart rate in the waiting room prior to randomisation


Hounsfield units






Multidetector computed tomography


Pulmonary vein computed tomography


ECG R-R interval


State-trait anxiety inventory



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.

Supplementary material

330_2016_4215_MOESM1_ESM.docx (23 kb)
ESM 1 (DOCX 23 kb)


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Ming Yen Ng
    • 1
    • 2
    Email author
  • Yasser Karimzad
    • 1
  • Ravi J. Menezes
    • 1
  • Bernd J. Wintersperger
    • 1
  • Qin Li
    • 1
  • Julian Forero
    • 1
  • Narinder S. Paul
    • 1
  • Elsie T. Nguyen
    • 1
  1. 1.Department of Medical Imaging, Toronto General HospitalUniversity of TorontoTorontoCanada
  2. 2.Department of Diagnostic RadiologyThe University of Hong Kong, Queen Mary HospitalHong KongHong Kong

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