SINUS NODE DECELERATION DURING EXERCISE AS A MARKER OF SIGNIFICANT NARROWING OF THE RIGHT CORONARY-ARTERY

The hallmark of exercise-induced ischemia is ST-segment depression on the exercise electrocardiogram. Other indicators of exercise-induced ischemia include ST-segment elevation, U-wave inversion, chronotropic incompetence, hypotension and ventricular ectopy.1 Sinus node deceleration, defined as an initial increase and subsequent decrease in heart rate with continued exercise at the same or higher work load, has not been described as a marker of coronary artery disease. We previously reported a patient with sinus node deceleration and subsequent resolution on repeat exercise testing after angioplasty of a right coronary artery stenosis.2 In this study, we report an additional 7 patients with sinus node deceleration, all of whom had angiographically confirmed disease of the right coronary artery. © 1993.