Letter to Editor: Diagnostic importance of aVR derivation in exercise stress testing for interpreting of multivessel and proximal LAD disease

Exercise stress testing (EST) is the most frequently used diagnostic method for diagnosing stable coronary artery disease (CAD). EST has some deficiencies due to its relatively low specificity and sensitivity. Many studies have been performed to improve the diagnostic accuracy of EST. The other occupation has become definition the localization of ischemia. Herein electrocardiographic parameters especially ST segment elevation in aVR derivation have been evaluated for this subject. The importance of ST elevation in aVR has been demonstrated in the setting of acute coronary syndrome (1, 2) and latest studies investigated value of aVR derivation in EST. In a retrospective screening study reported that exercise-induced ST-segment elevation in lead aVR is a sensitive (92.9%), but not specific (48.6%), electrocardiographic finding of significant left main coronary artery (LMCA) disease (3).