Diagnostic value of atrial pacing and thallium-201 scintigraphy for the assessment of patients with chest pain

Journal Article · Sat Apr 01 04:00:00 EST 1989 · Clin. Cardiol.; (United States)

DOI:https://doi.org/10.1002/clc.4960120404· OSTI ID:6073727

Stratmann, H G; Mark, A L; Walter, K E; Williams, G A

Atrial pacing was performed either alone (n = 23) or in combination with thallium-201 scintigraphy (n = 113) in 136 patients referred for evaluation of chest pain. The presence of coronary artery disease (CAD) was excluded by cardiac catheterization in 12 patients and confirmed in 124. Both pacing-induced ST depression and angina had sensitivities of 48% for CAD; specificities were 75% and 83%, respectively. An abnormal thallium-201 scan (one or more reversible and/or fixed perfusion defects) was seen in 72% of patients with CAD (specificity 83%). Reversible perfusion defects were present in 47% of patients with CAD (specificity 83%), and fixed defects in 36% (specificity 100%). Pacing was associated with either ST depression or an abnormal perfusion scan in 81% of patients (specificity 67%). There were no significant differences in the results of atria pacing or thallium-201 scintigraphy in patients with or without a history of myocardial infarction, or in those with or without previous coronary artery bypass surgery. Pacing-induced ST depression, or both ST depression and a reversible perfusion defect occurred significantly less frequently in patients with peripheral vascular disease than in those without this diagnosis (p less than .05). With only one exception, there were no significant differences in the sensitivities of any indicators of ischemia (ST depression, angina, or perfusion scans), either individually or in combination, as the peak pacing rate or double product achieved increased.

• Research Organization: St. Louis VA Medical Center, MO (USA)
• OSTI ID: 6073727
• Journal Information: Clin. Cardiol.; (United States), Journal Name: Clin. Cardiol.; (United States) Vol. 12:4; ISSN CLCAD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PAIN
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SENSITIVITY ANALYSIS
SPECIFICITY
SYMPTOMS
THALLIUM 201
THALLIUM ISOTOPES