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contentuptodate· Content· item f11_17_11548

©2013 UpToDate ® Print Email 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. 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.