Editorial

 

Good results only if MTWA stress / pacing protocols and patient preparation are the standard ones.

 

Stress and Pacing Protocols

 

The Stress protocol that has been used in one European trial recently published was the first protocol used before year 2001. Since year 2001 the stress and pacing suggested protocols have been changed.

 

In this European trial the old stress protocol is described (3 minutes between 105 – 110bpm) and it was the same one used from the same investigators group in one paper published in 2001 (with MTWA tests executed in 1997-2000 ) probably to compare results.

 

The changes in the new protocol (2,5 minutes between 100 -110 bpm AND at least 1,5 minutes over 110 bpm), have been developed because if  MTWA  appears near 110bpm  there is not enough time for the interpretation software to decide if MTWA is sustained or not).

 

Therefore since 2001 the protocol was updated to have at least 1.5 minutes over 110bpm but the MTWA report interpretation remains the same.

 

The new Pacing protocol requires Atrial ( or AV sequential with AV delay of 180msec) pacing for 5 minutes at 109 – 110bpm (550msec).

 

 

Patient preparation and MTWA system use

 

To avoid technically inadequate tests ( that are different from indeterminate tests ), the user should be trained for 1 day and the results of the first group of tests ( of the following days) should be sent to the trainer for consultancy. A second additional training is frequently requested.

To meet the requirement of a second training, a Training DVD for retraining of the sites who are willing to learn more how optimally execute a test, is now available.

 

The Training DVD should be requested to the MTWA company clinical specialist.

 

Daniele Marangoni

Editor

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