Effect of contrast material osmolality on the electrocardiogram during intrauterine injection.

RATIONALE AND OBJECTIVES: In a previous study, intrauterine injection of meglumine-sodium diatrizoate (high osmolar contrast media) during hysterosalpingography was found to induce lengthening of the QTc interval on electrocardiography. To evaluate the relationship between high osmolality and electrocardiographic changes during intrauterine injection, the authors evaluated the effect on QTc of two ionic contrast agents with different osmolality during routine hysterosalpingography. METHODS: Forty-eight women undergoing routine hysterosalpingography were included in the study. Thirty-two women received meglumine-sodium diatrizoate (1500 mOsm/kg) and 16 received meglumine-sodium ioxaglate (600 mOsm/kg). QTc changes were evaluated using a 12 lead computerized electrocardiogram system during all the stages of the procedure. RESULTS: In the meglumine-sodium diatrizoate group, QTc interval was prolonged significantly from 419 +/- 19 msec at baseline to 447 +/- 30 msec during injection of contrast material, P < .001, and returned to baseline values in late phase (416 +/- 18 msec). The meglumine-sodium ioxaglate group showed no change in the QTc interval. CONCLUSION: As the single major difference between the two ionic agents is osmolality, we believe that QTc interval prolongation in the meglumine-sodium diatrizoate group is related to increased osmolality.