Document Detail

Diagnosis of coronary artery disease by exercise thallium-201 tomography in patients with a right ventricular pacemaker.
MedLine Citation:
PMID:  9137216     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to study the accuracy of exercise perfusion scintigraphy in patients with an implanted apical right ventricular pacemaker. BACKGROUND: The specificity of exercise perfusion scintigraphy is decreased in patients with a left bundle branch block. Patients with a permanent ventricular pacemaker have a similar conduction abnormality that may also potentially result in similar false positive perfusion defects. METHODS: One hundred five patients with a right ventricular pacemaker underwent exercise thallium-201 tomography and coronary angiography within 7 days of each other. Patients with a previous myocardial infarction were excluded. RESULTS: Patients were classified into four groups according to the agreement or disagreement between the thallium tomographic and coronary angiographic results. Only 8% of patients with normal results by both techniques were continuously paced during exercise, compared with 78% of patients with normal angiographic results but abnormal scintigraphic results. The mean defect size was 12% in the latter group. Most of the false positive defects were localized to the inferoposterior (71%), apical (50%) and inferoseptal (28%) walls. CONCLUSIONS: Patients who are paced in the right ventricular apex and who continue to be paced throughout exercise have a high incidence of false positive thallium-201 single-photon emission computed tomographic defects.
N M Lakkis; Z X He; M S Verani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  29     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-03     Completed Date:  1997-06-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1221-5     Citation Subset:  AIM; IM    
Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
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MeSH Terms
Bundle-Branch Block / physiopathology,  therapy
Case-Control Studies
Cohort Studies
Coronary Angiography
Coronary Disease / diagnosis,  physiopathology,  radionuclide imaging*
Exercise Test
False Positive Reactions
Heart / radionuclide imaging*
Pacemaker, Artificial*
Predictive Value of Tests
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left / physiology
Reg. No./Substance:
0/Thallium Radioisotopes

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