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Effects of External Counterpulsation on Myocardial Ischemia Induced by Atrial Pacing

Twelve patients with coronary artery disease were studied during atrial pacing prior to and combined with external counterpulsation (ECP). During pacing combined with ECP, significantly higher peak and mean diastolic pressures occurred, although incidence of anginal pain, ECG changes of ischemia, and myocardial lactate extraction were similar, as were heart rate-systolic pressure product and coronary venous flow. Although ECP increases arterial peak and mean diastolic pressure, it failed to reverse clinical, ECG, and metabolic components of pacing induced ischemia, perhaps because it neither decreased myocardial oxygen requirement nor increased oxygen delivery.