ST-Heart Rate-Recovery Loops and Right Precordial Leads in Exercise Electrocardiography

Exercise electrocardiography remains the most cost-effective, convenient and widely utilized noninvasive approach for the detection of coronary artery disease (CAD). However, despite these advantages, imperfections in sensitivity and specificity of this approach have stimulated efforts to refine the diagnostic accuracy of this method (1,2). These innovations include analysis of ST segment heart rate-recovery loops and incorporation of additional leads to the standard 12-lead exercise electrocardiogram (ECG). Initial studies of these adjunctive approaches suggest their potential to improve the reliability of the exercise ECG for detecting CAD (3, 4, 5, 6). This chapter considers the value and limitations of these techniques in the assessment of patients for CAD.