Assessment of Rapid Atrial Pacing in the Diagnosis of Coronary Artery Disease.
10.4070/kcj.1991.21.6.1152
- Author:
Jae Gu LEE
;
Dae Seok SIM
;
Gun Ho KIM
;
Keun Hong LEE
;
Sung Ho KIM
;
Moon Hong DOH
;
Bong Gwan SEO
;
Jin Hak CHOI
- Publication Type:Original Article
- Keywords:
Pacing stress test;
ST segment change;
Hemodynamic change
- MeSH:
Constriction, Pathologic;
Coronary Artery Disease*;
Coronary Vessels*;
Depression;
Diagnosis*;
Electrocardiography;
Exercise Test;
Humans;
Relaxation;
Sensitivity and Specificity;
Thorax
- From:Korean Circulation Journal
1991;21(6):1152-1158
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The sensitivity and specificity of ST segment change on ECG for detection of coronary artery disease(CAD) by pacing stress test were assessed. Among 28 cases with chest pain(mean age 52, M/F : 21/7), 10 patients had normal coronary angiographic finding(Group I), and 18 had coronary artery disease(Group II). Pacing stress test showed high specificity(100%), but low sensitivity(61%) for the diagnosis of CAD. Especially in patients with 1 vessel disease, the sensitivity was only 50%, and positive results were not attained unless there was at least 90% or more stenosis in any of the major branches(LAD, RCA or LCX). But in patients with multivessel disease, the sensitivity was much higher(83%). Lateral(V4-6) or inferior leads(2, 3, aVF) showed ischemic ST segment depression most commonly. Therefore one of the inferior lead and V5 may be a minimum requirement for monitoring pacing-induced ST segment changes. Time constant during isovolumic relaxation showed statistically significant prolongation after pacing only in CAD patient group, suggesting pacing-induced impairment of early left ventricular relaxation.
