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[Echocardiography during transesophageal atrial pacing. Its applicability and diagnostic value]
J Salas Nieto1, J López Candel, M Villegas García
1Seccion de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia.
Insights
Atrial pacing combined with echocardiography offers a highly sensitive method for detecting coronary artery disease, proving safer and more effective than conventional stress tests. This approach enhances diagnostic accuracy for ischemic conditions.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Atrial pacing is an alternative to isotonic exercise for inducing ischemia.
- It is utilized in stress echocardiography for assessing coronary artery disease (CAD).
Purpose of the Study:
- To evaluate the applicability and diagnostic value of atrial pacing with two-dimensional echocardiography for CAD detection.
Main Methods:
- 52 patients with suspected ischemic disease underwent atrial pacing stress echocardiography.
- The study assessed regional wall motion abnormalities and combined data with ECG and angina presence.
Main Results:
- The procedure was completed in 44 patients (84.7% applicability).
- Echocardiography showed 88% sensitivity, 68% specificity, and 79% accuracy for regional wall motion abnormalities.
- Adding ECG or angina data increased sensitivity to 96%.
Conclusions:
- Transthoracic two-dimensional echocardiography during atrial pacing is a safe and highly sensitive method for CAD detection.
- Limitations for routine clinical use were analyzed.
Introduction And Objectives:
Atrial pacing has been proposed as an alternative method to the isotonic exercise, to induce ischemia, and, joined to two-dimensional echocardiography, as one of the main modalities in stress echo. In order to analyse its applicability and diagnostic value in assessing coronary artery disease this study was undertaken.
Patients And Methods:
52 patients referred to coronarography for suspicion or evaluation of ischemic disease, were submitted to this technique.
Results:
The study was completed in 44 patients (applicability rate of 84,7%). The results obtained showed a sensitivity, specificity and diagnostic accuracy for the regional wall motion abnormalities echocardiographically detected, of 88%, 68% and 79%, respectively. When electrocardiographic changes or presence of angina during atrial pacing were added to echocardiographic data, sensitivity increased to 96%. In 41 patients in which a conventional stress test was available, sensitivity was 55% electrocardiographically, 33% clinically and 68% globally.
Conclusions:
It is concluded that transthoracic two-dimensional echocardiography during atrial pacing is a safe, highly sensitive method for coronary artery disease detection. The limitations of the method for its routine clinical application are also analysed.