Occurrence of atrial fibrillation during dobutamine stress echocardiography: Incidence, risk factors, and outcomes

Seth H. Sheldon, J. Wells Askew, Kyle W. Klarich, Christopher G. Scott, Patricia A. Pellikka, Robert B. McCully

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: The reported incidence of atrial fibrillation (AF) occurring during dobutamine stress echocardiography (DSE) ranges from 0.5% to 4%. The aim of this study was to characterize the incidence, risk factors, and outcomes of AF precipitated during DSE. Methods: The clinical and echocardiographic data of consecutive patients over a 50-month period who were in sinus rhythm and underwent DSE were retrospectively reviewed. Results: A total of 11,806 consecutive patients underwent DSE and met all inclusion criteria. AF developed during DSE in 122 patients (1%), 71 of whom had histories of AF. The duration of AF was <1 hour in 74 patients (61%) and <24 hours in 117 patients (96%). Of the 47 patients who were still in AF when dismissed from the echocardiography laboratory, 21 had outpatient follow-up within 24 hours, eight were already inpatients, and 18 were triaged to the emergency department or hospital. Spontaneous cardioversion occurred in 114 patients (93%). There were no reported complications. The clinical characteristic most strongly associated with the development of AF during DSE was a history of AF (odds ratio, 18.4 if no history of congestive heart failure; P < .001). The presence or extent of stress-induced myocardial ischemia was not predictive of the development of AF. Conclusions: AF is an infrequent complication of DSE. Most patients return to sinus rhythm spontaneously within 1 hour. Patients with persistent AF can be safely dismissed from the echocardiography laboratory to have outpatient follow-up within 24 hours unless they have suboptimal heart rate control, hypotension, significant symptoms, or markedly abnormal findings on DSE.

Original languageEnglish (US)
Pages (from-to)86-90
Number of pages5
JournalJournal of the American Society of Echocardiography
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2011

Keywords

  • Atrial fibrillation
  • Dobutamine
  • Stress echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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