Copyright © 1982 by the European Society of Cardiology.
© 1982 by The European Society of Cardiology
Complications of exercise testing
A survey in three German-speaking countries
Department of Cardiology, University of Frankfurt am Main West Germany
Received 19 December 1980; revised 18 December 1981; .
Requests for reprints to: Prof. Dr M. Kaltenbach, Klinikum der Johann Wolfgang Goethe-Universitat, Abteilung fur Kardiologie, Theodor-Stern-Kai 7, D 6000 Frankfurt am Main 70, West Germany.
Abstract
A survey was carried out of 1 065 923 individual exercise tests performed at 198 sites in three German-speaking countries.
Seventeen deaths were reported among 712 285 patients, in 80% of whom coronary heart disease was either established, suspected, or ruled out. Fatal complications were unrelated to exercise technique, attained workload, or selection. The cause of death in these patients was myocardial infarction; 10 additional non-fatal infarctions were reported.
Among 353 638 young, apparently healthy, athletes, no deaths or life-threatening complications were reported.
The most common non-fatal, life-threatening complication was ventricular fibrillation, which occurred at a rate of 1.4 per 10 000 tests employing bicycle ergometry. It was not observed among 83 000 procedures with an arm-assisted step test.
In comparison to the results from the United States in the National Survey of Exercise Stress Testing (1980) the mortality rate in Europe appears to be lower (Europe 0.25 per 10 000, U.S.A. 0.5 per 10 000). In addition, the total number of severe complications was lower in Europe (Europe 1.4 per 10 000, U.S.A. 8.8 per 10 000).
It is concluded that exercise testing is a relatively safe procedure when all possible precautions, including the availability of a defibrillator, have been taken. The observed differences in the non-fatal complication rates for various types of exercise require further clarification.
Key Words: Bicycle ergometry • treadmill exercise • arm-assisted step test
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