title: Predictive value of atrial pacing test for survival of patients with coronary artery disease.
abstract: There is evidence that patients with signs of poor left ventricular function or marked ischemia at low work load during an exercise test have a poor prognosis for survival. To determine whether a pacing test can provide similar information, the 6-yr survival rate was computed in 118 medically-treated patients who had undergone a standardized atrial pacing test. Among the 118 patients, 80 had significant coronary artery disease (CAD). The variables measured for the atrial pacing test were: induced angina, myocardial lactate extraction (MLE), maximal heart rate (MHR) and left ventricular end-diastolic pressure (LVEDP) changes. There was no death in 38 patients without significant CAD. The 6-yr survival rate of the 80 patients with CAD was 84 +/- 4% (+/- SEM). Of all the variables, the combinations of MHR less than or equal to 150 beats min-1 during pacing associated with a LVEDP increase greater than or equal to 5 mmHg immediately after pacing or with MLE less than or equal to 0% during pacing constituted the best predictors. Patients with a MHR less than or equal to 150 beats min-1 and a LVEDP increase greater than or equal to 5 mmHg had a 6-yr survival of 56 +/- 12% in comparison to 92 +/- 3% for the remaining patients (P less than 0.001). Patients with a MHR less than or equal to 150 beats min-1 and MLE less than or equal to 0% during pacing had a 6-yr survival of 64 +/- 11% in comparison to 91 +/- 4% for the remaining patients (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002304:Cardiac Pacing, Artificial; D003327:Coronary Disease / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged
chemical_list: D007773:Lactates; D019344:Lactic Acid