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