Computerized Exercise ECG in the Diagnosis of Critical Coronary Lesions

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Abstract
Different ECG criteria are evaluated with respect to their ability to identify individuals with critical lesions of the coronary arteries in a population of patients with severe angina. Six chest leads and the limb leads were recorded in 85 patients by computer during maximal, symptom-limited exercise ECG testing. Averaging of ECG complexes enhances the signal quality and makes it possible to use measurements of the limb leads recorded during exercise. Fourteen patients with abnormal Q waves in lead V2 were excluded from ST analysis. In the remaining 71 patients, more than 1/3 mm ST depression in lead I and/or more than 2.0 mm ST depression in any of the chest leads had a sensitivity of 85% and an specificity of 67% for lesions in the main stem and/or proximal LAD and/or 3-vessel disease. The predictive value of a positive test was 83%. This and other criteria were evaluated for different disease groups and at different stages during the exercise test.