Stress electrocardiography testing in coronary artery disease: Is it time for its swan song or to redefine its role in the modern era ?

Stress electrocardiography (sECG) or treadmill stress testing is a well validated noninvasive diagnostic modality available to clinicians at low cost yet providing valuable functional data for coronary artery disease (CAD) diagnostic and prognostic evaluation. With the advances in cardiac imaging in both functional and anatomic fronts and the existing limitations of sECG testing, this modality appears less favored worldwide as reflected in some recent guideline updates. We review the past present and future of sECG to provide a viewpoint on where it stands in CAD evaluation and if it will remain relevant as a diagnostic modality or be retired going forward. We also provide our perspectives on how sECG can co-exist with other modalities such as calcium scoring and discuss the role of such testing in the Indian population.

Preliminary study of using atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing / 中国基层医药

Objective To evaluate the usefulness of atropine in decreasing the number of tests with ineonclusire results in patients with a poor ehronotropic response or exercise capacity during treadmill stress testing(TET).Methods The study comprised 80 patients undergoing TET.In subjects experiencing fatigue at submaximal exercise,atropine was administered in doses of 0.5mg per minute until the test conclusion(positive test results or target heart rate aehieyed)or until a maxium dose of 2mg was administered and some exercise during no use atropine 64 patients control group compare observe.Results 80 patients reguired atropine(mean dose,1mg)during the study;proceeded to achieve their target heart rate(n=68,85%)or positive test results(n=45,56%)the mean increase in heart rate after atropine administration was(25±11)beats/min(range 5～54 beats/min).Atropine administration resulted in conclusive tests more often in subjects with poor chronotropic response than in subjects with poor exercise capacity was 56% vs not receiving atropine 22%(P＜0.01).Conclusion The use of atropine as adjunct to standard TET can help decrease the number of inconclusive teats.