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Pacing Stress Echocardiography

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Stress Echocardiography

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Abstract

Pacing stress acts through electrical stimulation of heart rate, with little, if any, increase in systolic blood pressure and a mild increase in contractility, with a reduction of left ventricular end-diastolic and end-systolic volumes in healthy subjects. Heart rate also decreases diastolic coronary perfusion and oxygen supply. Stress testing with pacing is best performed with external programming of a permanent pacemaker with atrial stimulation or biventricular mode to obtain a normal, physiologic pattern of septal motion. The recommended protocol is with stepwise 1-min increments from 100 up to 150 or more beats per minute. The accelerated protocol (30 s or less per step) achieves higher sensitivity and shorter imaging time than the standard protocol with 10 beats increase every 3 min. Pacing stress is safer, faster, and more feasible than physical and pharmacological stresses and does not require intravenous line as pharmacological stresses, or the capability to exercise as physical stresses. Noninvasive pacing stress can be performed with state-of-the-art ABCD protocol, with a slightly lower success rate than vasodilator stress for the more challenging step of coronary flow velocity reserve. Permanent pacemaker stress echocardiography is a convenient, efficient, and safe stress test for the large and expanding population of patients with electrical therapeutic devices.

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Author information

Authors and Affiliations

  1. Department of Cardiology, Pomeranian Medical University, Szczecin, Poland

    Edyta Płońska-Gościniak

  2. Institute of Clinical Physiology of the National Research Council, Pisa, Italy

    Eugenio Picano

Authors
  1. Edyta Płońska-Gościniak
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  2. Eugenio Picano
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Correspondence to Edyta Płońska-Gościniak .

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Editors and Affiliations

  1. Institute of Clinical Physiology of the National Research Council, Pisa, Italy

    Eugenio Picano

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Płońska-Gościniak, E., Picano, E. (2023). Pacing Stress Echocardiography. In: Picano, E. (eds) Stress Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-031-31062-1_21

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  • DOI: https://doi.org/10.1007/978-3-031-31062-1_21

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-031-31062-1

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