Original Article

Comparison of contrast ventriculography with stress echocardiography by transesophageal atrial pacing (TAP) for the evaluation of left ventricular regional wall motion abnormalities in coronary artery disease

  • Ahmet Yıldırım

İstanbul Med J 2005;6(2):1-10

Purpose:

To assess the !efi ventricular wall matian by two dimensiona/ stress echocardiography us ing transesophageal atrial pacing (TAP) in patients w ith coronary artery disease and comparison of contrast ventriculography.

Materials and Methods:

A total ofpatients (16 males and 3females) with coronary artery disease were evaluated. The TAP stimulator used in the study was created by us usıng a temporary pacemaker. A special electrode named as TAPSUL was used during TAP. The comparison of the results was made by Chı-Square test.

Results:

8 of 10 patients, who had previously assessed as having normal wall matian by ventriculography were dingnosed as havıng wall matian abnormality by echocardiography performed bejare TAP no wall matian abnormality has been diagnosed in the rest two patients simılar to the results of contrast ventriculography. Echocardiographıc wat/ matian abnormality has been dingnosed in 9 patıents in whom similar results had been seen by ventrıculography. In 9 of 10 patients having normal ventriculography, wall mation abnormality has been observed by echocardiography which was performed cifter TAP. However, in one patient wall matıon abnormality hasn 't been observed by both methods. In all of9 patıents having abnormal ventriculography wall matian abnormalıty has been diagnosed by echocardıography. However, the hypokinetic segments have been seen to change in to akinetic segments. Echocardiographic estimations of the cases were compared with each other bejare and after TAP. At the pacing rates of 100 bpm and 120 bpm, although there observed a slight increase in the number of hypokinetic segment alter TAP this increase was not significant versus the values of bejare TAP (p> 0.05). Frequency of akinesis significantly increased (p<0.01) but the increase in hypokinetic segment number was not significant at the pacing ra te of 140 1 bpm when alter TAP values were comparedwith those of the bejare TAP.

Conclusion:

lt ıs conc/uded that; stress echocardiography is a non-invasive method which performed by TAP in submaximal velocities might show wat/ matian abnormalities in important coronary heart disease s and it mig ht al so terminare tachycardia.

Keywords: Transesophageal atrinl pacing, stress echocardiography, TAPSUL