Utility of lead V4R in exercise testing for detection of coronary artery disease

Chouhan, Lalit; Krone, Ronald J.; Keller, Andrew J.; Eisenkramer, RN Gail

doi:10.1016/0002-9149(89)90847-3

Cited by 21 publications

(8 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The use of V 4 R, as an additional lead in the exercise test, was initially reported to improve detection of RCA stenosis [22,23]. ST-segment alterations in certain combinations of precordial leads (V1 and V2) and right-sided chest leads (V 3 R and V 4 R) are suggested to be indicative of the culprit vessel in patients with myocardial infarction, during the dobutamine stress test [24].…”

Section: Discussionmentioning

confidence: 99%

The significance of right-sided chest leads in exercise testing for the detection of right ventricular dysfunction post myocardial infarction of the inferior wall

Michaelides

Tousoulis

Liakos

et al. 2011

International Journal of Cardiology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

The significance of right-sided chest leads in exercise testing for the detection of right ventricular dysfunction post myocardial infarction of the inferior wall

Michaelides

Tousoulis

Liakos

et al. 2011

International Journal of Cardiology

View full text Add to dashboard Cite

“…21,22 ST-segment alterations in certain combinations of precordial leads (V 1 and V 2 ) and right-sided chest leads (V 3 R and V 4 R) are suggested to be indicative of the culprit vessel in patients with myocardial infarction during the dobutamine stress test. 23 Furthermore, we previously demonstrated that additional right-sided chest leads contributed to 1-vessel disease detection in 14% of patients with left anterior descending coronary artery stenosis, in 64% of patients with RCA stenosis, and in 41% of patients with LCX stenosis.…”

Section: Discussionmentioning

confidence: 99%

Right‐sided Chest Leads in Exercise Testing for Detection of Coronary Restenosis

Michaelides

Liakos

Antoniades

et al. 2010

Clinical Cardiology

View full text Add to dashboard Cite

Background: The incorporation of right-sided chest leads (V 3 R through V 5 R) into standard exercise testing has been reported to improve its diagnostic utility. Hypothesis: The purpose of this study was to evaluate any improvement in the ability of exercise testing in detecting restenosis, using additional V 3 R through V 5 R leads, in asymptomatic patients undergoing percutaneous coronary intervention (PCI) in the right coronary artery (RCA) or/and left circumflex (LCX). Methods: We studied 172 consecutive patients (54 ± 7 years old, 106 males) undergoing PCI in RCA or/and LCX. A treadmill test had been performed before PCI. Six months later, all patients underwent a second treadmill test and arteriography in order to detect silent ischemia due to restenosis. Recordings during exercise were obtained with the standard 12-leads plus V 3 R through V 5 R. Results: Out of 172 patients, 106 had stenosis in RCA, 35 in LCX, and 31 in both vessels while 6 months later, restenosis was detected in 8 (for RCA), 3 (for LCX), and 3 (for both vessels) patients respectively. Sensitivity, specificity, positive prognostic value, negative prognostic value, and accuracy of exercise testing performed post PCI were ameliorated using V 3 R through V 5 R (79% vs 57%, 97% vs 80%, 69% vs 21%, 98% vs 95%, and 95% vs 78% respectively, P < .05 for all except negative prognostic value). Maximal exercise-induced ST-segment deviation (in mm) was not changed post PCI in 12 leads (1.4 ± 0.2 vs 1.5 ± 0.2, P =NS) while it was decreased in V 3 R through V 5 R (0.2 ± 0.2 vs 1.2 ± 0.3, P < .01). Conclusions: The addition of V 3 R through V 5 R improves the diagnostic ability of standard exercise testing in detecting silent ischemia due to restenosis in patients undergoing PCI in RCA or/and LCX.

show abstract

“…Chouhan and coworkers replaced lead V2 with V4R in their assessment of 118 patients undergoing ETT and coronary angiography. 1 This innovation increased the sensitivity of the exercise ECG from 44% to 61% for the detection of isolated right coronary artery disease with Ͼ50% stenosis; from 47% to 67% if stenosis severity was Ͼ75%; and from 50% to 100% in patients with complete obstruction. It was noted that V4R may be the only lead to exhibit ST segment abnormalities during ETT in patients with isolated right coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Studies have reported that the addition of rightsided precordial leads can increase the sensitivity of the ETT for detecting right coronary artery disease with no change in specificity compared with the 12-lead electrocardiogram (ECG). 1,2 A posterior lead (V9) has improved the sensitivity of the traditional 12-lead ECG but has not been extensively studied in patients undergoing ETT.…”

mentioning

confidence: 99%

Use of Additional Electrocardiograph Leads in Low-Risk Patients Undergoing Exercise Treadmill Testing

Diercks¹,

Kirk²,

Turnipseed³

et al. 2006

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

View full text Add to dashboard Cite

show abstract

Utility of lead V4R in exercise testing for detection of coronary artery disease

Cited by 21 publications

References 5 publications

The significance of right-sided chest leads in exercise testing for the detection of right ventricular dysfunction post myocardial infarction of the inferior wall

The significance of right-sided chest leads in exercise testing for the detection of right ventricular dysfunction post myocardial infarction of the inferior wall

Right‐sided Chest Leads in Exercise Testing for Detection of Coronary Restenosis

Use of Additional Electrocardiograph Leads in Low-Risk Patients Undergoing Exercise Treadmill Testing

Contact Info

Product

Resources

About