Document Detail

Interatrial block during exercise tolerance tests as an additional parameter for the diagnosis of ischemic heart disease.
MedLine Citation:
PMID:  16226091     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Interatrial block (IAB; P-wave duration, >or=120 milliseconds) is associated with increases of left atrial pressure. We studied the use of IAB during exercise tolerance test (ETT) in diagnosis of ischemic heart disease. METHOD: Exercise tolerance tests were performed in 149 patients (mean age, 50 years; male, 60.4%). P-wave duration was measured at rest, at each stage of exercise using the Bruce protocol, and in recovery. As clinically indicated, 71 patients subsequently underwent nuclear stress test and/or catheterization. The evidence of ischemia (EOI) was considered present according to the more definite test, that is, catheterization over nuclear stress test over ETT. RESULTS: Among patients who did not have IAB at rest (n=115), 63 patients (54.7%) developed IAB during the ETT. The incidence of IAB during the ETT was higher in patients with EOI than patients without EOI (88.9% vs 51.9%, P=.03). When IAB during the ETT and positive ETT were used together to detect EOI, they were more accurate (86.1% vs 81.7%) than the ETT alone. Among patients with IAB at rest (n=34), patients with EOI had a higher incidence of P-wave duration increase of more than 20 milliseconds during the recovery period than patients without EOI (100% vs 21.8%, P=.015). When using P-wave duration increase of more than 20 milliseconds during the recovery period in conjunction with positive ETT, the sensitivity in detecting EOI was higher than using the ETT alone (100% vs 0%), but the specificity was worsened (68.8% vs 84.4%). CONCLUSION: New IAB and worsening of IAB during ETT appeared in patients with ischemic heart disease and may be used as additional parameters for the ETT interpretation.
Sirin Apiyasawat; Anish J Thomas; David H Spodick
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  38     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-17     Completed Date:  2006-04-13     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-3     Citation Subset:  IM    
Department of Medicine, Worcester Medical Center, and Division of Cardiovascular Medicine, University of Massachusetts Medical Center, Worcester, MA 01655, USA.
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MeSH Terms
Exercise Test
Exercise Tolerance*
Heart Atria / physiopathology
Heart Block / diagnosis*,  epidemiology,  physiopathology*
Middle Aged
Myocardial Ischemia / diagnosis*,  epidemiology,  physiopathology*
Prospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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