Early experience with esophageal pill electrode atrial pacing in the diagnosis of coronary artery disease--a trend toward improved specificity compared to treadmill exercise.

Esophageal pill electrode pacing, treadmill exercise and coronary angiography were performed in 23 patients with chest pain. Atrial pacing produced fewer false positive studies resulting in higher specificity compared to treadmill exercise. Some possible explanations of the improved specificity are the better quality tracings obtained with atrial pacing and the increased control of the heart rate and blood pressure response during atrial pacing as opposed to treadmill exercise. This preliminary study suggests that esophageal pill electrode atrial pacing tachycardia studies may be a reasonable alternative to treadmill exercise testing in the noninvasive diagnosis of coronary artery disease.