Which arrhythmias are relative indications for stopping a maximal exercise test?

Which arrhythmias are relative indications for stopping a maximal exercise test?

• A. Non-sustained arrhythmias such as multifocal ectopy, ventricular triplets, SVT, and bradyarrhythmias that may become complex or affect haemodynamics require consideration for stopping
• B. Sustained VT
• C. Atrial flutter with rapid ventricular response
• D. Ventricular fibrillation

Answer: (C)

In a maximal exercise test, some rhythm disturbances are considered relative reasons to halt, meaning you pause and reassess based on stability and symptoms. Atrial flutter with a rapid ventricular response is a classic example because the fast rate shortens filling time and lowers cardiac output. During intense exercise the heart’s demand is high, so a rapid atrial flutter can lead to dizziness, chest pain, hypotension, or ischemia. If the rhythm is well tolerated and coagulation/hemodynamics remain stable, testing may continue, but you should stop promptly if symptoms or signs of instability appear. This is different from true emergencies like sustained ventricular tachycardia or ventricular fibrillation, which require immediate termination due to high risk of collapse. Non-sustained arrhythmias or bradyarrhythmias that don’t cause symptoms or hemodynamic problems are typically monitored rather than automatically stopping the test.

In a maximal exercise test, some rhythm disturbances are considered relative reasons to halt, meaning you pause and reassess based on stability and symptoms. Atrial flutter with a rapid ventricular response is a classic example because the fast rate shortens filling time and lowers cardiac output. During intense exercise the heart’s demand is high, so a rapid atrial flutter can lead to dizziness, chest pain, hypotension, or ischemia. If the rhythm is well tolerated and coagulation/hemodynamics remain stable, testing may continue, but you should stop promptly if symptoms or signs of instability appear. This is different from true emergencies like sustained ventricular tachycardia or ventricular fibrillation, which require immediate termination due to high risk of collapse. Non-sustained arrhythmias or bradyarrhythmias that don’t cause symptoms or hemodynamic problems are typically monitored rather than automatically stopping the test.