Transesophageal Atrial Pacing during Scintigraphic Tomography Exams

The significance of scintigraphic, echocardiographic and electrocardiographic left atrial transesophageal pacing in diagnosis of ischemic heart disease.

Kowalczyk R, Gawor Z, Maziarz Z, Goch A, Drobinski R, Malkowski B, Grycewicz T, Goch JH, Kosmider M, Adamus J. Klinika Kardiologii SK WAM w Lodzi. Pol Arch Med Wewn 1998 Mar;99(3):186-94. The aim of the study was to compare the perfusion scintigraphy (using SPECT method with Tc-99-MIBI) during left atrial transoesophageal pacing test (LAPT) with pacing electrocardiography (ECG), echocardiography (ECHO) and electrocardiography exercise test (ExT) in ischaemic heart disease (IHD) diagnostics. The effect of LATP on heart haemodynamic parameters and the correlation between scintigraphic, echocardiographic and electrocardiographic parameters during LAPT test have been also assessed. Investigations were carried out in 55 subjects (Group I: 36 patients with effort angina pectoris; group II: controls: 19 clinically healthy subjects). Coronarography was performed in 24 patients 6 weeks before or after examinations. LATP test was analyzed with ECG, ECHO and SPECT. Echocardiography did not increase significantly the LATP test diagnostic value. Perfusion scintigraphy enhanced sensitivity and predictive excluding value LATP test. These values were 93.3% v 62.9% and 90% v 59.3% respectively. LATP test assessed with ECG, ECHO and perfusion scintigraphy expressed significantly higher sensitivity and predicting excluding value in comparison to ExT. LATP test analyzed in such way was characterized by 100% sensitivity and 100% predicting excluding value. CONCLUSION: Combination of LATP with electrocardiography, echocardiography and SPECT is a non-invasive high quality method for ischaemic heart disease diagnostics.

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