Mashima Y, Ishinaga T, Komatsu C, Kawakami K. Department of Nuclear Medicine and Radiological Sciences, Tokyo Metropolitan Geriatric Hospital. Kaku Igaku 1990 Aug;27(8):877-81. The stress study for Tl-201 myocardial SPECT (single photon emission computed tomography) of a patient with old myocardial infarction, who had occasionally felt a chest pain for the last 8 months was performed with the transesophageal atrial pacing. The examination was fastly started and regular pacing rates were completely obtained for every pacing rate (50-100/min). In spite of a little amount of the pacing stress, the finding of stress induced ischemia and MI were obtained on this patient. This result suggests that the transesophageal atrial pacing stress might be useful for the evaluation of ischemic heart disease by Tl-201 myocardial SPECT, and is easily applied to the old and the patient with disorder of leg movement.