TEMPORAL ELECTRICAL HETEROGENEITY FOR DETECTING CORONARY-ARTERY DISEASE - RESULTS IN A HETEROGENEOUS CARDIAC POPULATION

BACKGROUND A new 22-lead electrocardiographic test has been advocated as a screening tool for coronary artery disease and has been shown to have accuracy similar to stress electrocardiography in specific patien t populations. OBJECTIVE To determine the accuracy of this test for de tecting coronary artery disease in patients undergoing coronary angiog raphy for a variety of cardiac conditions. METHODS We prospectively de termined the temporal electrical heterogeneity (TEH) index at rest in 70 patients who had no angina or Q waves on the resting 12-lead electr ocardiogram before they underwent coronary angiography. RESULTS Twenty -six of the 70 patients had significant coronary artery disease, defin ed as 70% stenosis or greater in at least one major epicardial coronar y artery. A TEH index of 80 or more had a sensitivity of 58%, a specif icity of 75%, and a positive predictive value of 58%. The group with s ignificant coronary disease had a mean TEH index of 77.2, and the grou p without coronary disease had a mean index of 65.5 (P = .02), despite similar clinical characteristics and indications for angiography. CON CLUSION The TEH index shows promise as a screening tool for coronary a rtery disease in a heterogeneous cardiac population. However, larger s tudies are needed before it can be endorsed for widespread clinical us e.