ACC/AHA guideline summary: Exercise testing for arrhythmia evaluation

Class I - There is evidence and/or general agreement that exercise testing for arrhythmia evaluation should be performed for the following indications:

• To identify the appropriate settings in patients with rate adaptive pacemakers.

• To evaluate patients with congenital complete heart block patients prior to initiation of increased physical activity or participation in competitive sports.

Class IIa - The weight of evidence or opinion is in favor of benefit from exercise testing for arrhythmia evaluation for the following indications:

• To evaluate suspected exercise-induced arrhythmias.

• As part of the evaluation for medical, surgical, or ablative therapy in patients with known exercise-induced arrhythmias, including atrial fibrillation.

Class IIb - The evidence or opinion is less well established that exercise testing for arrhythmia evaluation is beneficial for the following indications:

• To evaluate ventricular premature beats in middle-aged patients without evidence of coronary artery disease.

• To evaluate young patients with first-degree atrioventricular block, type I (Wenckebach) second degree atrioventricular block, left bundle branch block, right bundle branch block, or isolated ectopic beats prior to participation in competitive sports.

Class III - There is evidence that exercise testing for arrhythmia evaluation is not useful and may be harmful in the following setting:

• As part of the routine evaluation of isolated ectopic beats in young patients.

ACC_AHA_exercise_arrhythmia.htm

Data from Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002; 106:1883.

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ACC/AHA guideline summary: Exercise testing for arrhythmia evaluation