Objectives: Performance of exercise stress testing depends on adequate workload and is limited by patients' inability to reach target heart rate due to noncardiac illness or medications such as beta-blockers. This study aimed to assess the utility of atropine administration to augment the chronotropic response of patients undergoing treadmill exercise stress echocardiography. Methods: In a retrospective study, we assessed the utility of atropine administration to augment the chronotropic response in 1,396 patients undergoing treadmill exercise stress echocardiography between January 2004 and January 2009, compared with a historical control group with no atropine augmentation. Results: Atropine was well tolerated. The proportion of abnormal studies differed significantly between patients who underwent exercise with and without atropine augmentation (15% vs. 10%; P < 0.0001). Compared with the historical control group, the proportion of patients who achieved ≥85% of their target heart rates increased from 67% to 78% (P < 0.0001). Conclusions: While atropine augmentation is safe and feasible, further studies are required to determine whether it is an equivalent surrogate to achieving target heart rate through exercise alone.
- chronotropic incompetence
- stress echocardiography