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Excerpt
Methods Six patients with pacemaker and suspected CAD (4 females and 2 males, age range 55–80 years) were stressed through their pacemakers. An electrophysiology technician (trained in handling pacemakers) performs the procedure. The technique involves increasing the heart rate gradually through the patient's pacemaker using a magnet and the radiopharmaceutical injected when the patient reaches 85% of the expected target heart rate (THR). The heart rate is maintained for at least 2 min post-injection before bringing them to the baseline. The images are acquired 1 h post-injection. No adverse effects were noted. The procedure took 5–7 min.
Results Five out of 6 patients had abnormal scans. Four patients had reversible ischaemia (two had widespread ischaemia involving multiple territories) and 1 patient had an equivocal scan (reversible ischaemia/artefact). One patient had a hypotensive response.
Conclusion External pacing to achieve the required THR in asthmatic patients with pacemaker is a useful technique. However, liaison with the referring physician and the cardiology team is important.
