Dobutamine stress echocardiography (DSE) is a widely used examination for assessment
of coronary ischemia, but several complications have been reported. The aim of this
study was to assess the incidence of atrial fibrillation (AF) during DSE, and a systematic
review and meta-analysis were also performed to determine an accurate estimate of
the AF incidence. Over a 16-year period, we reviewed all patients referred for DSE.
We systematically analyzed all ECG performed during DSE to detect AF during the examination.
DSE was completely performed in 4,818 patients (mean age: 62.1 ± 11.7 years). AF was
observed in 40 patients (31 men, mean age: 79.7 ± 8.9 years). Incidence of AF during
DSE was 0.83%. Regarding the meta-analysis, the combined AF incidence was 0.86%. In
our study, patients with AF occurrence had more frequent previous history of paroxysmal
AF (p = 0.02) were also older (p < 0.0001) and incidence of AF during DSE increased
with age: 0% below 60 years, 0.45% in patients 60 to 69 years, 1.3% in patients 70
to 79 years, and 4% in patients >80 years (p < 0.0001). In multivariate analysis,
the factors significantly associated with an increased risk of AF were age (adjusted
odds ratio (aOR) = 2.4, 95% confidence interval: 1.5 to 3.3, p = 0.003) and previous
history of paroxysmal AF (aOR = 1.5, 95% confidence interval: 1.1 to 1.9; p = 0.04).
In conclusion, AF is uncommon during DSE, and elderly patients and patients with previous
history of paroxysmal AF are at risk of AF during DSE.
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Article info
Publication history
Published online: January 31, 2019
Received in revised form:
December 31,
2018
Received:
October 2,
2018
Identification
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