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I think this slows my heart rate down too much and causes the extra beats to be thrown in. I've found that when I'm at rest is when I have the issues. I've gotten a 2nd opinion and was switched to metoprolol. We'll see if that works better.
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I have stable angina and about a year ago I started on Diltiazem every morning. It provides me with the relief I need causing no side effects at the same time. Before Diltiazem I have been taking a couple of other medications, also prescribed by my GP, but I wasn't absolutely happy with the results. With Diltiazem the pain is gone and I sleep without waking up the whole night. I would recommend this medication to all stable angina sufferers.

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We are talking about LIMA from the right radial?

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At times, having the patient take in a breath will lift the catheter and help canulation of the coronary.

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You can use any catheter that points upwards (Tiger, Jacky, AL1, 2, 3 or even LIMA) and just advance Baby J wire and invariably it will go to Lt.

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IA is better than IV, reason mentioned (acidic, negatively charged, avoids first pass effect and probably more local effect compare to IV and also vasodilator) We almost never sedate pt.

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For now I go to femoral if good pulse and no significant PVD and use closure device.

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The following postmarketing events have been reported infrequently in patients receiving diltiazem: acute generalized exanthematous pustulosis, allergic reactions, alopecia, angioedema (including facial or periorbital edema), asystole, erythema multiforme (including Stevens-Johnson syndrome, toxic epidermal necrolysis), exfoliative dermatitis, extrapyramidal symptoms, gingival hyperplasia, hemolytic anemia, increased bleeding time, leukopenia, photosensitivity (including lichenoid keratosis and hyperpigmentation at sun-exposed skin areas), purpura, retinopathy, myopathy, and thrombocytopenia.

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