PMID: 9446063Jan 31, 1998Paper

Hypokinetic arrhythmia, paradoxical chronotropic reaction and hypotension during dobutamine stress test

Minerva cardioangiologica
R VillaniS Nava

Abstract

The aim of this study was to evaluate the incidence of hypokinetic arrhythmias, bradycardiac (BR) and hypotensive reactions in a population of 775 patients during dobutamine stress test (DST): 281 patients (36.2%, group I) were symptomatic for thoracic pain without any history of coronary artery disease (CAD); 494 patients (63.8%, group II) were evaluated 3-4 weeks after an acute myocardial infarction (AMI) to stratify ischemic risk. None of these patients was receiving coronarodilating therapy. DST was performed using an infusion of 5, 10, 20, 40 micrograms/kg/min for 5 minutes during the first two stages and for 3 minutes during subsequent stages, and was accompanied by EKG and echocardiographic monitoring. BR was defined as severe when heart rate diminished more than 40 b/min, moderate when the decrease ranged between 20 and 39 b/min, and mild when the decrease was less than 20 b/min. A total of 34 (4.38%) BR were observed, 19 (55%) in group I and 15 (45%) in group II. BR were severe in 12 patients (35.9%), 3 with recent AMI (2 inferior and 1 anterior) and 9 without a history of CAD. Fifteen (45%) presented moderate BR, 8 with recent AMI (6 inferior and 2 anterior); 7 cases were in group I. Mild BR was observed in 7 patients...Continue Reading

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