Controlled Heart Rate by Atrial Pacing in Angina Pectoris

This study was undertaken with a consideration of the physiological relationship between myocardial oxygen consumption and heart rate. Atrial pacing was performed in 63 resting subjects, 36 of whom had been referred for evaluation of angina pectoris. Pacing at critical controlled heart rates evoked angina pectoris in six patients of this group with chest pain and, consistently and more frequently, produced significant S-T segmental depression in 28 patients as a manifestation of myocardial ischemia. The functional test employing controlled heart rates has several advantages over other stress tests. The use of the sole stress of controlled atrial tachycardia is a new technique which has provided relatively safe, reproducible results in the objective evaluation and investigation of myocardial ischemia.