Document Detail

Correlation of coronary artery stenosis site with anterior or inferior projection of ST changes induced by treadmill exercise using a newly devised 9-lead Holter method.
MedLine Citation:
PMID:  1304417     Owner:  NLM     Status:  MEDLINE    
A 9-lead Holter monitor using the lead-switching technique (9-lead DCG) and conventional 12-lead electrocardiograph (12-lead ECG) were simultaneously used for recording during treadmill exercise testing (Td-test) in 140 patients with coronary artery disease. Coronary arteriography was performed in 118 of the 140 patients, and the correlation between coronary stenosis and anterior or inferior projection of ST depressions occurring during the Td-test was investigated. Additionally, 10 patients with acute myocardial infarction (AMI) were studied to test ST elevation detection by the 9-lead DCG. The CM5 lead demonstrated ST depressions in 92 of the 109 patients showing ST depressions in one or more leads. High lateral (HL) and/or low lateral leads detected all ST depressions occurring in the I and aVL leads of the 12-lead ECG. Leads CM1, CM2 and CM3 exhibited low sensitivity (0-32%) and high specificity (56-100%), while leads CM4, CM5, and CM6 provided greater sensitivity (66-95%), but less specificity (3-32%) in detecting diseases of the left anterior descending artery, left circumflex artery and/or right coronary artery (RCA). In contrast, the low back (LB) lead demonstrated high sensitivity (88%) and high specificity (86%) in detecting RCA disease. Lead CM3 detected ST elevations in all 6 patients with anterior AMI, while the LB lead did so in all 4 patients with inferior AMI. With a Holter monitor, 4 leads are needed: CM5 like, CM3 like, lateral (such as HL) and inferior (such as LB). The LB lead is useful in detecting inferior ischemia.
T Tanabe; K Yoshioka; K Takahasi; K Usui
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiology     Volume:  81     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  1992  
Date Detail:
Created Date:  1993-07-08     Completed Date:  1993-07-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  351-64     Citation Subset:  IM    
Department of Cardiology, Tokai University School of Medicine, Isehara, Japan.
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MeSH Terms
Angina Pectoris / diagnosis,  physiopathology
Coronary Angiography
Coronary Disease / diagnosis*,  physiopathology
Electrocardiography, Ambulatory / instrumentation*
Exercise Test / instrumentation*
Heart Conduction System / physiopathology
Middle Aged
Myocardial Ischemia / diagnosis*,  physiopathology
Signal Processing, Computer-Assisted / instrumentation*

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