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Occurrence of Atrial Fibrillation during Dobutamine Stress Echocardiography: Incidence, Risk Factors, and Outcomes.
MedLine Citation:
PMID:  21172598     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The reported incidence of atrial fibrillation (AF) occurring during dobutamine stress echocardiography (DSE) ranges from 0.5% to 4%. The aim of this study was to characterize the incidence, risk factors, and outcomes of AF precipitated during DSE.
METHODS: The clinical and echocardiographic data of consecutive patients over a 50-month period who were in sinus rhythm and underwent DSE were retrospectively reviewed.
RESULTS: A total of 11,806 consecutive patients underwent DSE and met all inclusion criteria. AF developed during DSE in 122 patients (1%), 71 of whom had histories of AF. The duration of AF was <1 hour in 74 patients (61%) and <24 hours in 117 patients (96%). Of the 47 patients who were still in AF when dismissed from the echocardiography laboratory, 21 had outpatient follow-up within 24 hours, eight were already inpatients, and 18 were triaged to the emergency department or hospital. Spontaneous cardioversion occurred in 114 patients (93%). There were no reported complications. The clinical characteristic most strongly associated with the development of AF during DSE was a history of AF (odds ratio, 18.4 if no history of congestive heart failure; P < .001). The presence or extent of stress-induced myocardial ischemia was not predictive of the development of AF.
CONCLUSIONS: AF is an infrequent complication of DSE. Most patients return to sinus rhythm spontaneously within 1 hour. Patients with persistent AF can be safely dismissed from the echocardiography laboratory to have outpatient follow-up within 24 hours unless they have suboptimal heart rate control, hypotension, significant symptoms, or markedly abnormal findings on DSE.
Authors:
Seth H Sheldon; J Wells Askew; Kyle W Klarich; Christopher G Scott; Patricia A Pellikka; Robert B McCully
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  24     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
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