The electrocardiographic response to maximal treadmill exercise of asymptomatic men with right bundle branch block.

This study presents the results of maximal treadmill testing and cardiac catheterization in 40 asymptomatic and apparently healthy men with acquired right bundle-branch block. Eight of the men had significant angiographic coronary artery disease, and six of the eight only had single-vessel disease. The 40 men had normal maximal oxygen consumptions, normal maximal heart rates, and normal maximal blood pressure responses; none of the men had abnormal ST-segment changes in response to maximal treadmill testing. Thus, the sensitivity of exercise testing for coronary artery disease in men with right bundle branch block is uncertain. However, the apparently high specificity of exercise testing demonstrated by this study necessitates further evaluation for coronary artery disease in men with right bundle branch block who develop abnormal ST-segment depression in response to exercise testing.