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R-wave amplitude responses to rapid atrial pacing: a marker for myocardial ischemia.

Abstract：

:Atrial pacing-induced changes in the sum of R-wave amplitude were measured in leads V5, X, Y, and Z at rates of 100 bpm (phase I), 150 bpm (phase II), and immediately after pacing (phase III) in 33 patients undergoing cardiac catheterization for evaluation of chest pain. Seventeen (51%) patients showed evidence of ischemia during atrial pacing (typical anginal pain and/or at least a 1 mm ST-segment depression) and 16 (49%) showed no evidence of ischemia. Mean R-wave amplitude changes from baseline in the ischemic patients were: phase I: -8% (p = not significant), phase II: +3% (p = not significant), and phase III: +13% (p less than 0.01); and in nonischemic patients: phase I: -11% (p less than 0.02), phase II: -18% (p less than 0.01), and phase III: +2% (p = not significant). These two distinct patterns of R-wave amplitude changes were highly sensitive (85%), specific (92%), and predictive (92%) for identifying patients with myocardial ischemia but did not correlate (p = not significant) with either the angiographically determined extent of coronary artery obstructive disease (CAD), resting left ventricular function, or the dynamic, atrial pacing-induced changes in left ventricular dimensions determined by M-mode and two-dimensional echocardiography. Thus, R-wave amplitude changes induced by atrial pacing can be used to identify patients with myocardial ischemia independent of coronary anatomy or resting left ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Am Heart J

journal_title

American heart journal

authors

David D,Kitchen JG 3rd,Michelson EL,Naito M,Sawin HS,Chen CC

doi

10.1016/0002-8703(84)90133-9

subject

Has Abstract

pub_date

1984-01-01 00:00:00

pages

53-61

issue

1

eissn

0002-8703

issn

1097-6744

pii

0002-8703(84)90133-9

journal_volume

107

pub_type

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