[Significance of ST segment and R wave changes in exercise-induced supraventricular extrasystole]

Area of Science:

• Cardiology
• Exercise Physiology
• Diagnostic Electrocardiography

Context:

• Exercise testing is crucial for diagnosing coronary artery disease (CAD).
• Supraventricular extrasystoles (SVES) during exercise can complicate test interpretation.
• Evaluating electrocardiographic (ECG) changes during SVES may enhance diagnostic accuracy.

Purpose:

• To investigate the diagnostic utility of ST segment and R wave changes during SVES in patients undergoing exercise testing and coronary arteriography.
• To determine if these ECG parameters can improve the detection of significant coronary artery disease.

Summary:

• This retrospective study analyzed 23 patients with exercise-induced SVES, comparing ECG findings in those with and without obstructive CAD.
• Measurements included ST depression and R wave amplitude in both SVES and preceding sinus beats, calculating differences (ST(e-s), R(e-s)).
• A combined value (ST(e-s) + R(e-s) > 0 mV) was observed in 13/18 patients with CAD, and none without, suggesting diagnostic potential and improved interpretation of false-negative/positive exercise tests.

Impact:

• The findings suggest that analyzing ST segment and R wave variations during SVES can serve as a valuable supplementary criterion for diagnosing coronary artery disease.
• This approach may enhance the sensitivity and specificity of exercise stress tests, particularly in cases with equivocal results.