Detection of XXXX by two-dimensional echocardiography and transesophageal atrial pacing.

@entity1 @entity662 @entity66 @entity854 @entity453
Two-dimensional echocardiography was performed at rest and during rapid transesophageal atrial pacing in 85 @entity1 undergoing coronary arteriography for evaluation of @entity662 . Transesophageal atrial pacing was performed with 10 ms pulses of 6 to 27 mA intensity; the rate was progressively increased up to 150 beats/min. Four @entity1 were excluded: two because atrial capture was not achieved and two because of chest discomfort induced during transesophageal atrial pacing. Of the remaining 81 @entity1 , 56 had significant @entity453 (greater than or equal to 75% stenosis of at least one major coronary vessel) and 25 had no significant @entity453 ; 25 of the 56 @entity1 with @entity453 had no wall motion abnormalities at rest. The test was considered positive if wall motion abnormalities were detected during pacing. @entity854 occurred in 3 of 25 @entity1 without @entity453 (specificity 88%) and in 51 of 56 @entity1 with @entity453 (sensitivity 91%). @entity854 developed in 20 of the 25 @entity1 with @entity453 and normal regional wall motion at rest (sensitivity 80%); sensitivity for one, two and three @entity66 was 85% (17 of 20 @entity1 ), 94% (15 of 16 @entity1 ) and 95% (19 of 20 @entity1 ), respectively. In @entity1 without @entity453 , wall motion score was 18 at rest and 17.7 +/- 0.9 during pacing (p = NS). In @entity1 with @entity453 , wall motion score decreased from 15.2 +/- 3.6 at rest to 11.6 +/- 4.1 during pacing (p less than 0.001). In @entity1 with @entity453 and normal regional wall motion at rest, wall motion score decreased from 18 at rest to 14.4 +/- 3.1 during pacing (p less than 0.001). Thus, two-dimensional echocardiography during transesophageal atrial pacing appears both sensitive and specific in detecting @entity1 with @entity453 . This new procedure is a feasible and reliable alternative to exercise two-dimensional echocardiography.
