Stress Echocardiography in Octogenarians: Transesophageal Atrial Pacing is Accurate, Safe, and Well Tolerated

Kobal, Sergio; Pollick, Charles; Atar, Shaul; Miyamoto, Takashi; Aslanian, Noune G; Neuman, Yoram; Tolstrup, Kirsten; Naqvi, Tasneem Z.; Luo, Hao; Macrum, Bruce L; Siegel, Robert J.

doi:10.1016/j.echo.2006.03.009

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…Thanks to these advantages, TAPSE has recently been proposed and successfully applied in several subgroups of patients, such as the elderly [35, 36], at the bedside in patients with new-onset chest pain [37], in patients with the so-called ‘X syndrome’ [38], and soon after a myocardial infarction [27]. On the other hand, one limitation of TAPSE is that it requires good acoustic windows and a stable sinus rhythm; thus, it is not feasible in patients with atrial fibrillation, and might not be used in patients with esophageal varices.…”

Section: Discussionmentioning

confidence: 99%

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Anselmi¹,

Pilati²,

Golia³

et al. 2008

Cardiology

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Objectives: It was the aim of this study to investigate the long-term value of transesophageal atrial pacing in predicting death in patients with known or suspected coronary artery disease. Background: Exercise, dobutamine and dipyridamole stress echocardiography are all effective in predicting cardiac death. Transesophageal atrial pacing stress echocardiography (TAPSE) is a safe alternative to pharmacologic tests, but no information is available on prognosis with TAPSE. Methods: One thousand and ten TAPSE were performed in 975 consecutive patients. TAPSE was feasible in 970 tests (96%); after exclusion of the 35 patients with more than 1 TAPSE and those 42 lost at follow-up (mean 4.5 ± 3.7 years, median 6 years), the final population consisted of 857 patients (675 males, 58 ± 9 years old). The Cox model was used to analyze the association of clinical, resting and TAPSE variables with cardiac death. Results: TAPSE was abnormal in 281 (32%) patients. There were 46 cardiac-related deaths (5%), 25 among the 281 patients with an abnormal test (8.9%) and 21 among the 576 patients with a normal test (3.6%). The predictors of cardiac death were age, previous revascularization, resting wall motion score index and its variation during TAPSE. Abnormal TAPSE significantly increases the value of models predicting cardiac death. Moreover, cardiac mortality increased progressively with the extent of the induced ischemia. Conclusions: TAPSE is a useful tool in predicting death in patients with known or suspected coronary artery disease and might be considered an alternative to pharmacologic stressors.

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Section: Discussionmentioning

confidence: 99%

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Anselmi¹,

Pilati²,

Golia³

et al. 2008

Cardiology

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show abstract

“…The method is frequently used as a diagnostic option in coronary artery disease patients, as a modification of the stress test or in TAS stress echocardiography, which correlates well with myocardial perfusion stress scintigraphy and coronary angiography [ 11,12 ].…”

Section: Introductionmentioning

confidence: 99%

Device and methods for performing transesophageal stimulation at reduced pacing current threshold

Anier¹,

Kaik²,

Meigas³

2008

Estonian J. Eng.

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In order to reduce pacing current threshold in transesophageal stimulation, a novel multichannel transesophageal pacemaker and multichannel esophageal lead has been developed. Three different approaches to reduce pacing current threshold were clinically studied. Precise positioning of the pacing dipole allowed reduction of pacing current threshold on average by 20% over the standard bipolar transesophageal method in approximately 50% of patients. Use of a chest electrode lowered pacing current by up to 7 mA over standard bipolar transesophageal method in 60% of patients. A novel method of combining very short electrical pulses (splitting the impulse) from different locations, which gives desired current density and pulse length in the target tissue, has been elaborated. As a result, the stimulation is less painful for the patient than the routinely used single 10 ms current pulse. The proposed methods allowed successful atrial capture in all patients.

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Method for Reducing Pacing Current Threshold at Transesophageal Stimulation

Anier

Kaik²,

Meigas

11th Mediterranean Conference on Medical and Biomedical Engineering and Computing 2007

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Stress Echocardiography in Octogenarians: Transesophageal Atrial Pacing is Accurate, Safe, and Well Tolerated

Cited by 5 publications

References 27 publications

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Ischemia Induced by Transesophageal Atrial Pacing Stress Echocardiography Predicts Long-Term Mortality

Device and methods for performing transesophageal stimulation at reduced pacing current threshold

Method for Reducing Pacing Current Threshold at Transesophageal Stimulation

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