Is ST-segment elevation during Dobutamine stress arrhythmogenic?

Masoor Kamalesh, Krishnaswamy Chandrasekaran, Chittur Sivaram, Marcia Armstrong, Lin Price, Ken DeMaster, Udho Thadani

Research output: Contribution to journalArticle

Abstract

Purpose: Electrocardiographic ST-segment elevation over non-Q waves leads during exercise testing is considered to be arrthmogenic and continuation of exercise is contraindicated. The arrythmogenic potential of ST-segment elevation during Dobutamine stress testing is not well defined. Methods: Between Nov. 1994 and Apr. 1995 of the 105 consecutive patients referred for Dobutamine stress-imaging study, 6 patients developed ST-elevation (0.5-3.0mm) during Dobutamine infusion. Dobutamine was infused i.v. in incremental doses of 10mcg/Kg/min to a maximum dose of 50mcg/Kg/min and atropine was added in incremental doses of 0.4mg i.v. to a maximum of 2.0mg to achieve a minimum heart rate of 85% PMHR (220-age). No attempt was made to stop the test due to ST-elevation. Results: No patient had sustained or nonsustained ventricular tachycardia. One patient had unifocal PVC's late in recovery and another one had frequent trigeminy in recovery. Echocardiography was positive for ischemia in the area corresponding to the leads with ST-elevation in all patients. Conclusion and clinical implications 1) ST-elevation during Dobutamine stress was not associated with serious ventricular arrhythmias, despite the fact that Dobutamine infusion itself is highly arrythmogenic at higher doses 2) Atropine did not increase the risk of arrhythmia in the presence of ST-elevation and high dose Dobutamine 3) Unlike exercise testing, ST-segment elevation alone should not be considered as an indication to terminate Dobutamine stress.

Original languageEnglish (US)
Pages (from-to)120S
JournalChest
Volume110
Issue number4 SUPPL.
StatePublished - Oct 1 1996
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Kamalesh, M., Chandrasekaran, K., Sivaram, C., Armstrong, M., Price, L., DeMaster, K., & Thadani, U. (1996). Is ST-segment elevation during Dobutamine stress arrhythmogenic? Chest, 110(4 SUPPL.), 120S.