Enhanced recognition of ischemia by three variable analysis of the exercise stress test.

Background: ECG ST-segment deviations have been the standard measure of coronary artery disease (CAD) during the exercise stress test (EST). Our past research has shown other ECG variables to be significant in EST. This study evaluates the benefit of routinely combining these variables in the detection of CAD.

Usefulness of p-wave duration to identify myocardial ischemia during exercise testing.

It is well recognized that ST-segment depression is due to subendocardial ischemia secondary to an increase in left ventricular end-diastolic pressure. The increase in left ventricular end-diastolic pressure is associated with increased left atrial pressure, resulting in left atrial wall distension that contributes to increasing P-wave duration (PWD). The objective of this study was to determine if PWD measured in leads II and V(5) during maximum exercise stress testing could be a reliable predictor of myocardial ischemia.