Cardiology

Original Research

Accuracy and Long-Term Prognostic Value of Pacing Stress Echocardiography Compared with Dipyridamole Tl201 Emission Computed Tomography in Patients with a Permanent Pacemaker and Known or Suspected Coronary Artery Disease

Shimoni S. · Goland S. · Livshitz S. · Arditi A. · Ayzenber O. · Kusniec F. · Gendelman G. · Edri O. · Lutati G. · Levi R. · Caspi A. · Epstein M.

Author affiliations

The Heart Institute, Kaplan Medical Center, Rehovot, Affiliated to the Hebrew University and Hadassah Medical School, Jerusalem, Israel

Keywords: Stress echocardiographyPermanent pacemakerCoronary artery disease

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Cardiology 2010;116:229–236
https://doi.org/10.1159/000319750

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Article / Publication Details

First-Page Preview
Abstract of Original Research

Received: January 12, 2010
Accepted: May 01, 2010
Published online: August 07, 2010
Issue release date: August 2010

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 4

ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)

For additional information: https://www.karger.com/CRD

Abstract

Objectives: Myocardial ischemia is difficult to assess by noninvasive methods in patients with a permanent pacemaker. Pacing stress echocardiography (PASE) has been used successfully in the detection of coronary artery disease (CAD). However, there are no data comparing PASE and other methods. Methods: We compared agreement and accuracy of PASE and radionuclide tomography (SPECT) in detecting CAD in 58 patients, mean age 75 ± 7 years, with a permanent pacemaker and known or suspected CAD. Thirty-nine patients underwent coronary angiography. The prognostic value of these tests was determined by prediction of cardiac events and cardiac death. Results: PASE and SPECT were positive in 39 and 43 patients, respectively. The agreement between the tests was 75%; kappa value 0.64. The sensitivity was 87 and 96% and the specificity 78 and 57%, respectively. With median follow-up of 51 months, there were 24 cardiac events and 8 cardiac deaths. Multivariable analysis determined that positive PASE was the only independent predictive factor associated with cardiac events and cardiac death. Conclusions: PASE is a feasible and effective method for detection of significant CAD in patients with permanent-pacemaker and allows effective risk stratification. PASE merits further study in larger prospective comparative studies.

© 2010 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Research

Received: January 12, 2010
Accepted: May 01, 2010
Published online: August 07, 2010
Issue release date: August 2010

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 4

ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)

For additional information: https://www.karger.com/CRD

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2010, Vol.116, No. 3

August 2010

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