Diagnostic and therapeutic technology assessment. Cardiokymography

Cardiokymography is one of several noninvasive techniques able to detect coronary artery disease. It can qualitatively determine abnormal left ventricular motion, and, based on animal models, this can be directly related to abnormalities in the left coronary artery. Abnormal motion of the anterolateral, posterolateral, or inferior wall is not detected. The sensitivity and specificity of the technique in detecting coronary artery disease in a high-risk group are similar to those of thallium scintigraphy. No comparison has been made with tomographic thallium imaging or echocardiography. Cardiokymography is generally used along with exercise ECG. Most DATTA panelists considered the device safe but believed its effectiveness had not been established. Many cited greater familiarity with radionuclide methods and satisfaction with the amount of information provided by current techniques. Forty percent (8/20) of the panelists considered this technique unacceptable. A major concern was the possibility of missing coronary artery disease that had not affected the anterior wall of the left ventricle. Panelists who offered an opinion represent the following areas of medical specialty: cardiovascular diseases (20) and cardiovascular surgery/thoracic surgery (two). Their board certification includes the American Board of Internal Medicine (18) and the American Board of Thoracic Surgery (two). Fifteen physicians had no opinion regarding safety and 17 physicians had no opinion regarding effectiveness.