title: Electrocardiographic profile of adenosine pharmacological stress testing.
abstract: Adenosine stress testing in conjunction with radionuclide myocardial perfusion imaging has become a common approach for the detection of coronary artery diseases in patients who are unable to perform adequate levels of exercise. However, specific electrocardiographic alterations during the test have been rarely described. Using a Chinese population, the aim of the present study was to provide a detailed electrocardiographic profile of adenosine stress testing. The study population included 1,168 consecutive outpatients who had undergone adenosine-induced stress myocardial perfusion imaging. Electrocardiographic data during and immediately following the adenosine infusion were collected, and the corresponding myocardial perfusion images were assessed. During adenosine infusion, 174 transient and 47 persistent arrhythmic events occurred in 110 patients (9.42%). Furthermore, frequent premature atrial contractions occurred in 65 individuals and frequent premature ventricular contractions were observed in 73 individuals. Atrioventricular block (AVB) occurred in 75 patients [first degree (I°) AVB, 16; second degree (II°) AVB, 58; third degree AVB, 1), while sinoatrial block occurred in eight patients. ST depression emerged in 69 patients. Patients with a baseline I° AVB had an increased risk of a II° AVB, and patients exhibiting baseline ST depression were more likely to have a further depressed ST segment during the stress test (odds ratio, 28.68 and 5.01, respectively; both P<0.001). Following adenosine infusion, 10 patients (0.86%) exhibited newly occurred arrhythmic events. However, no patient presented with acute myocardial infarction or sudden mortality. In conclusion, the results demonstrated that adenosine infusion was a safe method, despite the relatively high incidence of arrhythmic events. The majority of arrhythmias that occurred during infusion were transient, were reversible with the termination of infusion and did not indicate abnormal perfusion results.
authors.affiliation: Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Nuclear Medicine, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P.R. China.
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Electrophysiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P.R. China.
authors.forename: Lihui
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
authors.forename: Qingrong
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
authors.forename: Boqia
authors.initials: B
authors.lastname: Xie
keywords: Chinese population; adenosine; arrhythmia; electrocardiography; myocardial perfusion imaging