title: Systematic overview and clinical applications of pacing atrial stress echocardiography.
abstract: Pacing atrial stress echocardiography (PASE) has been studied over the past 3 decades for the evaluation of myocardial ischemia. Published studies suggest that PASE may be used as an alternative to exercise or pharmacologic stress imaging. The recent introduction of improved pacing electrodes, together with use of accelerated and shortened pacing protocols and improvements in transthoracic echocardiographic imaging techniques, makes PASE an appealing stress imaging method. A critical analysis of the diagnostic accuracy of PASE shows equivalence with other imaging stress modalities. PASE has been found to be highly feasible and accurate technique that may expedite the diagnosis and risk stratification of patients with coronary artery disease. This review addresses the history, hemodynamics, protocols, accuracy, clinical utility, and cost-effectiveness of PASE as well as elucidating its place among other stress modalities.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Texas Medical Branch, Galveston, Texas, USA.
authors.forename: Shreyas A
authors.initials: SA
authors.lastname: Modi
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Siegel
authors.forename: Yochai
authors.initials: Y
authors.lastname: Birnbaum
authors.forename: Shaul
authors.initials: S
authors.lastname: Atar
mesh_terms: D000818:Animals; D002304:Cardiac Pacing, Artificial; D025401:Echocardiography, Stress / Q000379:methods*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011379:Prognosis; D015203:Reproducibility of Results