Surveillance Stress Testing “POST-PCI” — A Future Class III Recommendation?

Sixty years of the Bruce protocol: reappraising the contemporary role of exercise stress testing with electrocardiographic monitoring

“…20,23,[51][52][53] Over a century ago, observations were made that patients with CVD could present ST segment changes in the ECG, namely during physical effort, thus creating a base on which further study would ensue. 20,21,23,53 Although pioneering works attempted to provide a framework for this assessment, a breakthrough occurred with the development of what would go on to become one of the most widely appraised tests in cardiovascular medicine, the use of ExECG with the Bruce protocol. 20,22,23 First presented by the late Robert Arthur Bruce (who, among other achievements, was to be the first chief of Cardiology at the University of Washington School of Medicine, now sometimes being recalled as the Father of Exercise Cardiology) and colleagues, this protocol provided a standardized rigorous methodology for the dynamic assessment of CVD.…”

“… 15 , 17 , 18 Notably, already in the early days of its use, the electrocardiographic response to exercise was a focus of interest. 19 - 21 Since these first descriptions, different protocols were applied to provide a dynamic overview of the cardiovascular system during exercise. 19 , 20 Among these, the Bruce protocol, first introduced 60 years ago, was to be particularly important.…”