Noninvasive external cardiac pacing for thallium-201 scintigraphy

Marc D Feldman, S. E. Warren, E. V. Gervino, J. M. Aroesty, H. D. Royal, J. A. Parker, K. J. Silverman, G. M. Kolodny, P. M. Zoll, R. G. McKay

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Improvements in noninvasive external cardiac pacing have led to a technique with reliable electrical capture and tolerable patient discomfort. To assess the use of this modality of pacing in combination with thallium scintigraphy as a noninvasive pacing stress test, we applied simultaneous noninvasive cardiac pacing, hemodynamic monitoring, and thallium-201 scintigraphy in 14 patients undergoing cardiac catheterization for chest pain syndromes. Two patients had normal coronary arteries, while the remaining 12 had significant coronary artery disease. Thallium scintigraphic responses to pacing were compared to routine exercise thallium stress testing in nine of these 14 patients. All patients were noninvasively paced to more than 85% of the age-predicted maximum heart rate. Twelve patients demonstrated reversible thallium defects, which corresponded in 11 cases to significant lesions seen on coronary angiography. Of nine patients who underwent both pacing and exercise thallium stress tests, comparable maximal rate-pressure products were achieved. Moreover, thallium imaging at peak pacing and during delayed views did not differ significantly from exercise thallium scintigraphy. A limiting factor associated with the technique was local patient discomfort, which occurred to some degree in all patients. We conclude that noninvasive external cardiac pacing together with thallium scintigraphy is capable of detecting significant coronary artery disease and may be comparable to routine exercise thallium stress testing. This new modality of stress testing could be useful in patients unable to undergo the exercise required for standard exercise tolerance testing, particularly if improvements in the technology can be found to reduce further the local discomfort.

Original languageEnglish (US)
Pages (from-to)172-177
Number of pages6
JournalAmerican Journal of Physiologic Imaging
Volume3
Issue number4
StatePublished - 1988
Externally publishedYes

Fingerprint

Thallium
Radionuclide Imaging
Exercise
Exercise Test
Coronary Artery Disease
Exercise Tolerance
Cardiac Catheterization
Coronary Angiography
Chest Pain
Coronary Vessels
Heart Rate
Hemodynamics
Technology
Pressure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Feldman, M. D., Warren, S. E., Gervino, E. V., Aroesty, J. M., Royal, H. D., Parker, J. A., ... McKay, R. G. (1988). Noninvasive external cardiac pacing for thallium-201 scintigraphy. American Journal of Physiologic Imaging, 3(4), 172-177.

Noninvasive external cardiac pacing for thallium-201 scintigraphy. / Feldman, Marc D; Warren, S. E.; Gervino, E. V.; Aroesty, J. M.; Royal, H. D.; Parker, J. A.; Silverman, K. J.; Kolodny, G. M.; Zoll, P. M.; McKay, R. G.

In: American Journal of Physiologic Imaging, Vol. 3, No. 4, 1988, p. 172-177.

Research output: Contribution to journalArticle

Feldman, MD, Warren, SE, Gervino, EV, Aroesty, JM, Royal, HD, Parker, JA, Silverman, KJ, Kolodny, GM, Zoll, PM & McKay, RG 1988, 'Noninvasive external cardiac pacing for thallium-201 scintigraphy', American Journal of Physiologic Imaging, vol. 3, no. 4, pp. 172-177.
Feldman MD, Warren SE, Gervino EV, Aroesty JM, Royal HD, Parker JA et al. Noninvasive external cardiac pacing for thallium-201 scintigraphy. American Journal of Physiologic Imaging. 1988;3(4):172-177.
Feldman, Marc D ; Warren, S. E. ; Gervino, E. V. ; Aroesty, J. M. ; Royal, H. D. ; Parker, J. A. ; Silverman, K. J. ; Kolodny, G. M. ; Zoll, P. M. ; McKay, R. G. / Noninvasive external cardiac pacing for thallium-201 scintigraphy. In: American Journal of Physiologic Imaging. 1988 ; Vol. 3, No. 4. pp. 172-177.
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