Complications of ergometer exercise in children

Alpert, Bruce S.; Verrill, David E.; Flood, Nadine L.; Boineau, John P.; Strong, William B.

doi:10.1007/bf02076332

Cited by 30 publications

(9 citation statements)

References 6 publications

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“…5,6 In adults the risk of 1 myocardial infarction or death per 2500 exercise tests has been reported. 7 Because ischaemic heart disease is rare in children with CHD, the risk in children is lower than in adults.…”

Section: Contraindications For Exercise Testingmentioning

confidence: 99%

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Takken¹,

Blank²,

Hulzebos³

et al. 2009

NHJL

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Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are rare in children. The main indications for CPET in children are evaluation of exercise capacity and the identification of exercise-induced arrhythmias. In this article we will review the main indications for CPET in children with congenital heart disease, the contraindications for exercise testing and the indications for terminating an exercise test. Moreover, we will address the interpretation of gas exchange data from CPET in children with congenital heart disease. (Neth Heart J 2009;17:385-92.)

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Section: Contraindications For Exercise Testingmentioning

confidence: 99%

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Takken¹,

Blank²,

Hulzebos³

et al. 2009

NHJL

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“…Such a drop can occur in individuals without severe cardiac abnormalities. 25 It is generally recommended that blood pressure be measured (1) at rest before beginning the exercise test, (2) frequently during the exercise test to evaluate blood pressure elevation or to detect impending hypotension, and (3) during the recovery period to ensure that systolic blood pressure returns to near baseline values. In most tests, measurements every 3 minutes during exercise and recovery are adequate.…”

Section: Blood Pressure Measurementmentioning

confidence: 99%

Clinical Stress Testing in the Pediatric Age Group

Paridon¹,

Alpert²,

Boas³

et al. 2006

Circulation

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280

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Abstract-This statement is an updated report of the American Heart Association's previous publications on exercise in children. In this statement, exercise laboratory requirements for environment, equipment, staffing, and procedures are presented. Indications and contraindications to stress testing are discussed, as are types of testing protocols and the use of pharmacological stress protocols. Current stress laboratory practices are reviewed on the basis of a survey of pediatric cardiology training programs.

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“…They therefore concluded that ''any dysrhythmia initiated by exercise in the young should be considered abnormal.'' Alpert et al in 1983 published data on 1,730 children undergoing cycle ergometer testing, though roughly half of the patients were normal volunteers or patients with sickle cell disease or sickle cell trait [1]. In that series there were eight patients (0.5 %) with ''potentially hazardous arrhythmias'' including 4 children with VT. No child in that study required cardioversion or defibrillation.…”

Section: Discussionmentioning

confidence: 96%

The Prevalence of Arrhythmias, Predictors for Arrhythmias, and Safety of Exercise Stress Testing in Children

et al. 2014

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Exercise testing is commonly performed in children for evaluation of cardiac disease. Few data exist, however, on the prevalence, types of arrhythmias, predictors for arrhythmias, and safety of exercise testing in children. A retrospective review of all patients ≤21 years undergoing exercise testing at our center from 2008 to 2012 was performed. Patients with clinically relevant arrhythmias were compared to those not experiencing a significant arrhythmia. 1,037 tests were performed in 916 patients. The mean age was 14 ± 4 years, 537 (55 %) were male, 281 (27 %) had congenital heart disease, 178 (17 %) had a history of a prior arrhythmia, and 17 (2 %) had a pacemaker or ICD. 291 (28 %) patients had a rhythm disturbance during the procedure. Clinically important arrhythmias were noted in 34 (3 %) patients and included: 19 (1.8 %) increasing ectopy with exercise, 5 (0.5 %) VT, 5 (0.5 %) second degree AV block, 3 (0.3 %) SVT, and 2 (0.2 %) AFIB. On multivariate logistic regression, variables associated with the development of clinically relevant arrhythmias included severe left ventricular (LV) dysfunction on echo (OR 1.99, CI 1.20-3.30) and prior history of a documented arrhythmia (OR 2.94, CI 1.25-6.88). There were no adverse events related to testing with no patient requiring cardioversion, defibrillation, or acute anti-arrhythmic therapy. A total of 28 % of children developed a rhythm disturbance during exercise testing and 3 % were clinically important. Severe LV dysfunction and a history of documented arrhythmia were associated with the development of a clinically important arrhythmia.

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Complications of ergometer exercise in children

Cited by 30 publications

References 6 publications

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Clinical Stress Testing in the Pediatric Age Group

The Prevalence of Arrhythmias, Predictors for Arrhythmias, and Safety of Exercise Stress Testing in Children

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