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Do We Need Ekg Monitoring
During Stress Echocardiography?

Héctor R. Villarraga, Jairo Sánchez, Marisol Badiel,
Fernando Rosso, Pastor Olaya

Echocardiographic and Hemodinamic Laboratory,
Fundación Valle del Lili, Cali, Colombia

Introduction: Traditionally EKG monitoring has been used in stress echocardiography as wenow in the ischemia cascade changes in contractility are below electrical changes leaving the EKG monitoring mainly for arrhythmic complications.

Methods: Between September/97 and April/2000, a total of 2,571 stress echocardiogram (with exercise and dobutamine) were performed with an Acuson Sequoia C256 equipped with H3.5MHz frequency. The standard protocol of 3 minute stages of 5, 10, 20, 30, 40 and 50 mcg/Kg/min of DBT was used until at least 90% THR was reached If at 30 mcg/kg/min less than 70% of THR was achieved atropine in boluses of 0.25 mg was used up to a maximum of 2.0 mg, exercise was also performed until the same THR was accomplished. All the data was stored in EPI-INFO v.6.04. Our protocol includes one lead EKG monitoring for frequency purposes in the monitor of the ultrasound machine and 3 lead monitoring in the treadmill monitor when exercise is performed. After the exam is finished, the patient is observed for 20-30 minutes.

Results: 1,378 men (53.6%). Age: 58.7 ± 12.7 yr (23-95 yr). In a total of 2,571 pt the positivity or negativity of the test was based upon changes of regional contractility. Isolated supraventricular arrhythmias were seen in 1.17% of patients (n=30), and isolated ventricular: 1.4% (n=36), sudden death: 0.04% (n=1) with resuscitation and bradycardia 0.08% (n=2)

Conclusion: Electrocardiography monitoring is not essential in stress echocardiography, it is not relied upon for positivity or negativity of the test, and for arrhythmic purposes the EKG in the monitor can be used to guide therapy.

 

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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
President
Dr. Raúl Bretal
Scientific Committee
President
Dr. Armando Pacher
Technical Committee - CETIFAC
President
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