Open AccessElectrocardiographic evidence of ischemia during ventricular paced rhythms
Author(s) -
Diaz Claro F.,
Ganim Mazen S.,
Ellestad Myrvin H.
Publication year - 1996
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960190616
Subject(s) - medicine , cardiology , ischemia , electrocardiography , qrs complex , coronary artery disease , st depression , rhythm , left bundle branch block , myocardial ischemia , st segment , myocardial infarction , heart failure
Abstract Exercise‐induced electrocardiographic (ECG) changes are the most widely recognized noninvasive means for detecting myocardial ischemia. The specificity of these changes depends on the normalcy of the resting ECG. Right ventricular pacing produces major QRS and ST‐T changes very similar to those of complete left bundle‐branch block. They alter the resting ECG such that ischemic changes are considerably difficult to detect. Because of these resting abnormalities, ECG changes during treadmill exercise testing usually do not facilitate the diagnosis of ischemia or coronary artery disease. The following are two cases of ischemic ECG changes that occurred during right ventricular pacing. To our knowledge, there have been no reports of the classic ECG changes of ST‐segment depression suggestive of ischemia which occurred during right ventricular pacing and which were discemible from the resting ECG changes.