The Effect of Atrial Repolarization Waves on the Maximal Exercise Loading Test.
10.4070/kcj.1993.23.6.843
- Author:
Jong Soo CHOI
;
Gee Ho KIM
;
Moo In PARK
;
Byung Hun YUNN
;
Seung Jae JOO
;
Jae Woo LEE
- Publication Type:Original Article
- Keywords:
Atrial repolarization waves;
Exercise loading test
- MeSH:
Coronary Stenosis;
Depression;
Electrocardiography;
Exercise Test;
Heart Rate;
Humans;
Ischemia;
Myocardial Ischemia;
Sensitivity and Specificity
- From:Korean Circulation Journal
1993;23(6):843-850
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The atrial repolarization waves might contribute to ST segment depression during the exercise loading test. As atrial repolarization waves are opposite in direction to P waves, they could shift the ST segment in the absence of myocardial ischemia. METHODS: The exercise test in 20 patients was seemed false positive because of normal coronary angiogram. Twenty-six patients with at least one coronary stenosis > or =50% served as a true positive group. The P waves, PR segments and ST segment were studied in leads II, III, aVF and V4 to V6 in those 46 patients whose exercise ECG suggested ischemia. RESULTS: The finding of steeply downsloping PR segment, particularly in the inferior ECG leads, in patients with longer exercise time and higher exercise heart rate might predict a false positive exercise test in those with a normal rest ECG and no apparent reason for a false positive test. The combination of downsloping PR segments in two of three inferior leads plus either exercise duration > or =5 min or peak heart rate > or =130 bests/min idenified false positive tests with a sesitivity of 75% and a specificity of 81% to 89%. CONCLUSIONS: Atrial repolarization waves might play a role in exercise induced ST segment depression.
