title: Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification.
abstract: BACKGROUND
  Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy.
  
  
  METHODS
  We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification.
  
  
  RESULTS
  Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome.
  
  
  CONCLUSIONS
  Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes.
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, American University of Beirut Faculty of Medicine and Medical Center, Beirut, Lebanon.
authors.forename: Marwan M
authors.initials: MM
authors.lastname: Refaat
authors.forename: Mostafa
authors.initials: M
authors.lastname: Hotait
authors.forename: Zian H
authors.initials: ZH
authors.lastname: Tseng
mesh_terms: D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D018570:Risk Assessment
keywords: electrocardiography; electrophysiology; exercise electrocardiogram testing; risk stratification; sudden cardiac arrest; sudden cardiac death