Exercise testing and Thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome
In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionucl...
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| Veröffentlicht in: | J. Electrocardiol.; (United States) 1986-10, Vol.19 (4), p.319-326 |
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| creator | Poyatos, Maria Elena Suarez, Luis Lerman, Jorge Guibourg, Haydee Camps, Julio Perosio, Albino |
| description | In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Preexcitation persisted in 39.5% of patients with type A and in 88.8% with type B (p |
| doi_str_mv | 10.1016/S0022-0736(86)81059-7 |
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For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Preexcitation persisted in 39.5% of patients with type A and in 88.8% with type B (p<0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p<0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p<0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patient showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients in which the PE disappears suddenly, at a given heart rate. This has prognostic value because the probability of occurrence of severe tachyarrhythmias is higher as the refractory period of the anomalous way is shorter. Another conclusion of this study is the low specificity of ST-segment depression after exercise in patients with WPW, even in the cases in which PE disappears.</description><identifier>ISSN: 0022-0736</identifier><identifier>EISSN: 1532-8430</identifier><identifier>DOI: 10.1016/S0022-0736(86)81059-7</identifier><identifier>PMID: 3794571</identifier><identifier>CODEN: JECAB4</identifier><language>eng</language><publisher>Orlando, FL: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Angina Pectoris - diagnostic imaging ; BETA DECAY RADIOISOTOPES ; Biological and medical sciences ; BODY ; Cardiac dysrhythmias ; Cardiology. Vascular system ; CARDIOVASCULAR DISEASES ; CARDIOVASCULAR SYSTEM ; Coronary Circulation ; Coronary Disease - diagnostic imaging ; COUNTING TECHNIQUES ; DAYS LIVING RADIOISOTOPES ; DIAGNOSIS ; DIAGNOSTIC TECHNIQUES ; DISEASES ; Electrocardiography ; ELECTRON CAPTURE RADIOISOTOPES ; Exercise Test ; Female ; HEART ; Heart Rate ; HEAVY NUCLEI ; Humans ; ISOMERIC TRANSITION ISOTOPES ; ISOTOPES ; Male ; Medical sciences ; Middle Aged ; MYOCARDIAL INFARCTION ; Myocardial Infarction - diagnostic imaging ; NUCLEI ; ODD-EVEN NUCLEI ; ORGANS ; PATIENTS ; Prospective Studies ; RADIOISOTOPE SCANNING ; RADIOISOTOPES ; RADIOLOGY AND NUCLEAR MEDICINE ; Radionuclide Imaging ; SCINTISCANNING ; SECONDS LIVING RADIOISOTOPES ; Thallium ; THALLIUM 201 ; THALLIUM ISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics ; Wolff-Parkinson-White Syndrome - diagnostic imaging</subject><ispartof>J. Electrocardiol.; (United States), 1986-10, Vol.19 (4), p.319-326</ispartof><rights>1986 Research in Electrocardiology, Inc.</rights><rights>1987 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c331t-b2e74db7294b5508dc3524a35fd47389780b94f88f3b2c460f49fb85e3c634d3</citedby><cites>FETCH-LOGICAL-c331t-b2e74db7294b5508dc3524a35fd47389780b94f88f3b2c460f49fb85e3c634d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-0736(86)81059-7$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,885,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=7909872$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3794571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/6782040$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Poyatos, Maria Elena</creatorcontrib><creatorcontrib>Suarez, Luis</creatorcontrib><creatorcontrib>Lerman, Jorge</creatorcontrib><creatorcontrib>Guibourg, Haydee</creatorcontrib><creatorcontrib>Camps, Julio</creatorcontrib><creatorcontrib>Perosio, Albino</creatorcontrib><creatorcontrib>Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina</creatorcontrib><title>Exercise testing and Thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome</title><title>J. Electrocardiol.; (United States)</title><addtitle>J Electrocardiol</addtitle><description>In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Preexcitation persisted in 39.5% of patients with type A and in 88.8% with type B (p<0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p<0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p<0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patient showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients in which the PE disappears suddenly, at a given heart rate. This has prognostic value because the probability of occurrence of severe tachyarrhythmias is higher as the refractory period of the anomalous way is shorter. Another conclusion of this study is the low specificity of ST-segment depression after exercise in patients with WPW, even in the cases in which PE disappears.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Angina Pectoris - diagnostic imaging</subject><subject>BETA DECAY RADIOISOTOPES</subject><subject>Biological and medical sciences</subject><subject>BODY</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>CARDIOVASCULAR DISEASES</subject><subject>CARDIOVASCULAR SYSTEM</subject><subject>Coronary Circulation</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>COUNTING TECHNIQUES</subject><subject>DAYS LIVING RADIOISOTOPES</subject><subject>DIAGNOSIS</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DISEASES</subject><subject>Electrocardiography</subject><subject>ELECTRON CAPTURE RADIOISOTOPES</subject><subject>Exercise Test</subject><subject>Female</subject><subject>HEART</subject><subject>Heart Rate</subject><subject>HEAVY NUCLEI</subject><subject>Humans</subject><subject>ISOMERIC TRANSITION ISOTOPES</subject><subject>ISOTOPES</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>MYOCARDIAL INFARCTION</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>NUCLEI</subject><subject>ODD-EVEN NUCLEI</subject><subject>ORGANS</subject><subject>PATIENTS</subject><subject>Prospective Studies</subject><subject>RADIOISOTOPE SCANNING</subject><subject>RADIOISOTOPES</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radionuclide Imaging</subject><subject>SCINTISCANNING</subject><subject>SECONDS LIVING RADIOISOTOPES</subject><subject>Thallium</subject><subject>THALLIUM 201</subject><subject>THALLIUM ISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</subject><subject>Wolff-Parkinson-White Syndrome - diagnostic imaging</subject><issn>0022-0736</issn><issn>1532-8430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1986</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkd-K1DAUh4so6-zqIywEEdGLav61Sa9Ell0VFhQc2MuQpifbaJuMSbo6L-EzmzrD3AqBBM53kvzOV1WXBL8lmLTvvmFMaY0Fa1_L9o0kuOlq8ajakIbRWnKGH1ebE_K0Ok_pO8a4o4KeVWdMdLwRZFP9uf4N0bgEKEPKzt8j7Qe0HfU0uWWuKSZo3gej4-D0hHYQ7ZJc8CgZ57O7j3o37pHzKI-AzOS8MwWDBz0tOq9csGhXTuBzQr9cHtFdmKxFX3X84XwqwN3oMqC090MMMzyrnlg9JXh-3C-q7c319upTffvl4-erD7e1YYzkuqcg-NAL2vG-abAcDGso16yxAxdMdkLivuNWSst6aniLLe9sLxtgpmV8YBfVi8O1oWRWJUsGM5rgPZisWiEp5rhArw7QLoafS5mOml0yME3aQ1iSEoIS0RJewOYAmhhSimDVLrpZx70iWK2u1D9XahWhZFmrKyVK3-XxgaWfYTh1HeWU-stjXacyVhu1L6ZOmOhwJwUt2PsDBmVgDw7iGgi8gcHFNc8Q3H8-8hen7LIh</recordid><startdate>198610</startdate><enddate>198610</enddate><creator>Poyatos, Maria Elena</creator><creator>Suarez, Luis</creator><creator>Lerman, Jorge</creator><creator>Guibourg, Haydee</creator><creator>Camps, Julio</creator><creator>Perosio, Albino</creator><general>Elsevier Inc</general><general>Churchill Livingstone</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>198610</creationdate><title>Exercise testing and Thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome</title><author>Poyatos, Maria Elena ; Suarez, Luis ; Lerman, Jorge ; Guibourg, Haydee ; Camps, Julio ; Perosio, Albino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c331t-b2e74db7294b5508dc3524a35fd47389780b94f88f3b2c460f49fb85e3c634d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1986</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Angina Pectoris - diagnostic imaging</topic><topic>BETA DECAY RADIOISOTOPES</topic><topic>Biological and medical sciences</topic><topic>BODY</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>CARDIOVASCULAR DISEASES</topic><topic>CARDIOVASCULAR SYSTEM</topic><topic>Coronary Circulation</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>COUNTING TECHNIQUES</topic><topic>DAYS LIVING RADIOISOTOPES</topic><topic>DIAGNOSIS</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DISEASES</topic><topic>Electrocardiography</topic><topic>ELECTRON CAPTURE RADIOISOTOPES</topic><topic>Exercise Test</topic><topic>Female</topic><topic>HEART</topic><topic>Heart Rate</topic><topic>HEAVY NUCLEI</topic><topic>Humans</topic><topic>ISOMERIC TRANSITION ISOTOPES</topic><topic>ISOTOPES</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>MYOCARDIAL INFARCTION</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>NUCLEI</topic><topic>ODD-EVEN NUCLEI</topic><topic>ORGANS</topic><topic>PATIENTS</topic><topic>Prospective Studies</topic><topic>RADIOISOTOPE SCANNING</topic><topic>RADIOISOTOPES</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radionuclide Imaging</topic><topic>SCINTISCANNING</topic><topic>SECONDS LIVING RADIOISOTOPES</topic><topic>Thallium</topic><topic>THALLIUM 201</topic><topic>THALLIUM ISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</topic><topic>Wolff-Parkinson-White Syndrome - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poyatos, Maria Elena</creatorcontrib><creatorcontrib>Suarez, Luis</creatorcontrib><creatorcontrib>Lerman, Jorge</creatorcontrib><creatorcontrib>Guibourg, Haydee</creatorcontrib><creatorcontrib>Camps, Julio</creatorcontrib><creatorcontrib>Perosio, Albino</creatorcontrib><creatorcontrib>Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>J. Electrocardiol.; (United States)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poyatos, Maria Elena</au><au>Suarez, Luis</au><au>Lerman, Jorge</au><au>Guibourg, Haydee</au><au>Camps, Julio</au><au>Perosio, Albino</au><aucorp>Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise testing and Thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome</atitle><jtitle>J. Electrocardiol.; (United States)</jtitle><addtitle>J Electrocardiol</addtitle><date>1986-10</date><risdate>1986</risdate><volume>19</volume><issue>4</issue><spage>319</spage><epage>326</epage><pages>319-326</pages><issn>0022-0736</issn><eissn>1532-8430</eissn><coden>JECAB4</coden><abstract>In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Preexcitation persisted in 39.5% of patients with type A and in 88.8% with type B (p<0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p<0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p<0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patient showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients in which the PE disappears suddenly, at a given heart rate. This has prognostic value because the probability of occurrence of severe tachyarrhythmias is higher as the refractory period of the anomalous way is shorter. Another conclusion of this study is the low specificity of ST-segment depression after exercise in patients with WPW, even in the cases in which PE disappears.</abstract><cop>Orlando, FL</cop><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>3794571</pmid><doi>10.1016/S0022-0736(86)81059-7</doi><tpages>8</tpages></addata></record> |
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| ispartof | J. Electrocardiol.; (United States), 1986-10, Vol.19 (4), p.319-326 |
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| language | eng |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE |
| subjects | Adolescent Adult Angina Pectoris - diagnostic imaging BETA DECAY RADIOISOTOPES Biological and medical sciences BODY Cardiac dysrhythmias Cardiology. Vascular system CARDIOVASCULAR DISEASES CARDIOVASCULAR SYSTEM Coronary Circulation Coronary Disease - diagnostic imaging COUNTING TECHNIQUES DAYS LIVING RADIOISOTOPES DIAGNOSIS DIAGNOSTIC TECHNIQUES DISEASES Electrocardiography ELECTRON CAPTURE RADIOISOTOPES Exercise Test Female HEART Heart Rate HEAVY NUCLEI Humans ISOMERIC TRANSITION ISOTOPES ISOTOPES Male Medical sciences Middle Aged MYOCARDIAL INFARCTION Myocardial Infarction - diagnostic imaging NUCLEI ODD-EVEN NUCLEI ORGANS PATIENTS Prospective Studies RADIOISOTOPE SCANNING RADIOISOTOPES RADIOLOGY AND NUCLEAR MEDICINE Radionuclide Imaging SCINTISCANNING SECONDS LIVING RADIOISOTOPES Thallium THALLIUM 201 THALLIUM ISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics Wolff-Parkinson-White Syndrome - diagnostic imaging |
| title | Exercise testing and Thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome |
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