title: [Diagnostic significance of atrial stimulation in coronary insufficiency. Correlation with the exercise test and/or coronary angiography].
abstract: 140 patients underwent atrial stimulation and a triangular exercise test on the bicycle ergometer; coronary arteriography was carried out on 80 of them. Atrial stimulation is slightly more sensitive (74% compared with 68%) and significantly less specific (57% compared with 74%) than bicycle ergometry. It is valuable to combine the two tests as at least one of them is positive in 84% of subjects with a significant coronary lesion (larger than or equal 70%). "False positive" responses during the stimulation test occur especially where the ECG at rest shows evidence of the non-specific repolarisation disorders of coronary insufficiency; but these "false positives" are accompanied by angina during the test significantly less frequently than the true positives. It may be possible, on the basis of the accounts in the literature and on the present analysis, to establish a methodology for the atrial stimulation test which will increase its sensitivity slightly, but which will also increase, more importantly, its specificity. It may also be possible to reach, by progressive 2-minute steps, a rate which is slightly greater than the maximum rate according to Astrand's law, and to take less account of ST depression as a positive criterioe, and more of the appearance of pain; the fact that this pain is angina could be confirmed by a dual test using placebo and trinitrin.
mesh_terms: D000328:Adult; D000368:Aged; D000790:Angiocardiography; D016275:Atrial Function; D004558:Electric Stimulation / Q000379:methods; D005080:Exercise Test; D005189:False Positive Reactions; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged
vernacular_title: La valeur diagnostique de la stimulation auriculaire dans l'insuffisance coronarienne. Corrélation avec l'épreuve d'effort et/ou la coronarographie