Atrial Fibrillation During Dobutamine Stress Echocardiography: Patient Characteristics and Outcomes

Background: Aim of this study was to describe the clinical and echocardiographic characteristics as well as the outcome of adults who developed AF during DSE (du-butamine stress echocardiography). Methods: Retrospective review of clinical and echocardiographic data of 7026 patients in sinus rhythm who underwent DSE over a 60-months period was done. Results. Of 7026 patients undergoing DSE, 73 (1%) were complicated by AF. Prior history of AF was present in 17 (23%). Inducible ischemia was present in 15 (21%). Frequent premature atrial complexes were present at rest (15%) or during DSE (32%). Patients without resting echocardiographic abnormalities (n=11) developed AF only at high doses of dobutamine (>= 30 mu g/kg/min); all had AF duration <15 minutes; infrequently (9%) had inducible ischemia or need for short stay observation (9%). Among patients with resting echocardiographic abnormalities, 14 (23%) had inducible ischemia, 13 (21%) required hospitalization, and 7 underwent chemical (n=6) or electrical (n=1) cardioversion. Conclusion. AF occurs uncommonly in patients undergoing DSE and its outcome is primarily determined by the presence of underlying cardiac structural or functional abnormalities.