Safety of exercise stress testing in patients with abnormal concentrations of serum potassium.
The objective of this study was to determine the safety of performing exercise stress testing in patients with abnormal serum potassium concentrations. Data were reviewed from 9,084 patients (mean age 63 +/- 12 years) referred for exercise echocardiography who had serum potassium measured <48 hours before the test were reviewed, and the occurrence of arrhythmias during stress testing was determined. Of 10,272 studies, 9,067 (88%) were in patients with normokalemia and 1,205 (12%) were in patients with abnormal serum potassium concentrations: 309 (26%) with hypokalemia (mean 3.4 +/- 0.16 mmol/L) and 896 (74%) with hyperkalemia (mean 5.1 +/- 0.19 mmol/L). Ventricular and supraventricular ectopy were common during exercise. Only 1 patient (potassium 4.9 mmol/L) had sustained ventricular tachycardia; all other episodes were nonsustained. Although ventricular and supraventricular ectopy are common during exercise testing, life-threatening arrhythmias are not. Exercise testing is generally safe despite mild to moderate hypokalemia or hyperkalemia.
Modesto
Karen M
KM
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Møller
Jacob E
JE
Freeman
William K
WK
Shub
Clarence
C
Bailey
Kent R
KR
Pellikka
Patricia A
PA
D000367:Age Factors; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000453:epidemiology; D007008:Hypokalemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011188:Potassium / Q000097:blood*; D012449:Safety; D012737:Sex Factors; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000453:epidemiology
D011188:Potassium