Arq Bras Cardiol: Imagem cardiovasc 2018; 31(3): 168-174

Analyzing the Safety and Predictors of Arrhythmias during Dobutamine-Atropine Stress Echocardiography in a Non-Hospital Setting

DOI: 10.5935/2318-8219.20180025

Abstract

Background

Dobutamine-atropine stress echocardiography (DASE) is an accessible and important test, especially in patients under investigation for coronary artery disease. However, it is necessary to evaluate its safety, as it is used in patients with increasingly complex and serious conditions and in seniors.

Objective

To confirm the safety of DASE and evaluate the predictors of arrhythmias in a non-hospital setting.

Methods

DASE was performed to evaluate ischemia using the standard protocol of dobutamine infusion of 5 to 40 mcg/kg/min associated with atropine.

Results

From September to November 2010, 227 patients were evaluated prospectively. The mean age was 60.7 +/- 12.5 years old and 60.8% were females. Mean ejection fraction was 67.9 +/- 9. Among the adverse events, 12 patients presented hypertensive response, 466 had arrhythmia, 58 had headaches and 57 had precordial pain. No patient had acute myocardial infarction, ventricular fibrillation, cardiac rupture, asystole or death. As for the onset of significant arrhythmia, three patients had atrial fibrillation, 16 had sustained supraventricular tachycardia, 19 had non-sustained ventricular tachycardia and 2 had sustained ventricular tachycardia. In these patients, age (OR = 1.0559, p = 0.0002) and segmental contractility index at rest (SCIr) > 1 (OR 2.5039, p = 0.0354) were independent predictors for the onset significant arrhythmia during the test.

Conclusion

DASE was proven safe in this group of patients in a non-hospital setting. Age and SCIr > 1 were independent predictors for the onset of significant arrhythmia during the test. (Arq Bras Cardiol: Imagem cardiovasc. 2018;31(3):168-174)