Sustained ventricular tachycardia induced by dobutamine stress echocardiography: a prospective study.
OBJECTIVE
To investigate the prognostic significance and electrophysiological characteristics of dobutamine stress echo (DSE)-induced sustained monomorphic ventricular tachycardia (VT).


METHODS
In our department, 3022 DSE studies were carried out on 2688 patients, aged 54.7 +/- 11.8 years, over a 3.5 year period. Patients with DSE-induced VT were studied by means of coronary angiography and electrophysiological testing, and were followed-up for 17.8 +/- 9.3 months.


RESULTS
During DSE, nine patients (0.3%) developed sustained monomorphic VT. Four patients had coronary artery disease, one developed spontaneous right coronary artery (RCA) dissection during DSE, one patient had peripartum cardiomyopathy and the remainder had normal coronary arteries. Logistic regression analysis did not identify clinical parameters such as left ventricular ejection fraction, documentation of an ischaemic response or the presence of non-viable myocardial segments during DSE, that could predict the occurrence of DSE-induced VT. Monomorphic VT was inducible by electrophysiological testing in two patients with CAD and reduced LVEF. During follow-up, only these two patients developed VT.


CONCLUSIONS
Sustained monomorphic VT is a rare complication of DSE, with no predictive value for the identification of patients with coronary artery disease and no prognostic significance in patients with normal coronary arteries. No predictors of its occurrence were identified.
Katritsis
Demosthenes G
DG
Department of Cardiology, Athens Euroclinic, Greece. dkatrits@otenet.gr
Karabinos
Ilias
I
Papadopoulos
Anastasios
A
Simeonidis
Phevos
P
Korovesis
Socrates
S
Giazitzoglou
Eleftherios
E
Karvouni
Evangelia
E
Voridis
Eutychios
E
D017023:Coronary Angiography; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology*