Reduced test time by early identification of patients requiring atropine during dobutamine stress echocardiography

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
T J LewandowskiD S Bach

Abstract

In a randomized, controlled clinical trial, we evaluated the ability of an algorithm to identify, before peak stress, patients who will ultimately require atropine during dobutamine stress echocardiography. The effects of early atropine administration on test duration, atropine dose, dobutamine dose, and heart rate response also were studied. Compared with conventional atropine administration at peak dobutamine infusion, early atropine administration reduced test duration 8% (1.1 minutes, p = 0.02) and total dobutamine use 11% (0.41 mg/kg, p = 0.02) but required 90% more atropine (0.36 mg, p < 0.001). Conventional atropine administration resulted in a late, rapid rise in both heart rate and rate-pressure product. However, the heart rate and rate-pressure product curves for patients receiving early atropine paralleled those seen in patients not requiring atropine during dobutamine stress echocardiography. In conclusion, early atropine administration provides a more balanced stress and reduces test duration, thus decreasing total exposure to dobutamine and potentially increasing test efficiency.

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Citations

Feb 10, 2011·European Journal of Clinical Pharmacology·Anna BanaśMarek Droździk
Feb 28, 2002·The American Journal of Cardiology·Alessandra BrofferioJamshid Shirani
Nov 23, 2007·Cardiovascular Ultrasound·Giovanni MinardiMartina Sordi
Oct 28, 2010·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Charaslak Charoenpanichkit, W Gregory Hundley
May 16, 2015·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Vasken DilsizianRonald G Schwartz
Aug 24, 1999·Cardiology Clinics·D A Orsinelli, C J Daniels
Aug 8, 2006·Journal of Magnetic Resonance Imaging : JMRI·Sangeeta Mandapaka, William Gregory Hundley

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