Abstract: AIM: To study methods to control heart rate so as to obtain good image quality and accurate diagnosis in 64-slice CT coronary angiography. METHODS: Six hundred and fifty-four consecutive patients (control group with beta blocker, 352 cases; contrast group with mental intervention, 302 cases) with heart rate >75 beats/min underwent 64-slice CT coronary angiography. Image quality and postprocessing time between groups were compared. RESULTS: After taking measures to decrease and stabilize the heart rate, the heart rate decreased <70 beats/min in 340 patients (96.6%) except 12 (3.4%) in the control group. Coronary arteries of 347 patients (98.8%) were assessable. For the contrast group, 127 cases (42%) decreased <70 beats/min. Diagnostic results were obtained in 266/302 patients (88%). The mean postprocessing time was (12±5)min for the control group and (18±6)min for the contrast group. CONCLUSION: Heart rate has a vital impact on the coronary CTA image quality. Beta blocker reduces the heart rate and thus significantly improves the CTA image quality. Administration of medication is better than mental intervention in controlling heart rate.