GIBBONS
ET AL., 2002 GUIDELINE UPDATE FOR EXERCISE TESTING
Circulation 2002;106:1883-1892
ACC/AHA
2002 Guideline Update for Exercise Testing—Full
Text
A
Report of the American College of Cardiology/American Heart
Association Task Force on Practice Guidelines (Committee to
Update the 1997 Excercise Testing Guidelines)
Committee
Members
Raymond
J. Gibbons, MD, FACC, Chair, Gary J. Balady, MD, FACC,
J. Timothy Bricker, MD, FACC; Bernard R. Chaitman, MD, FACC,
FAHA; Gerald F. Fletcher, MD, FACC, FAHA; Victor F. Froelicher,
MD, FACC, FAHA; Daniel B. Mark, MD, MPH, FACC, FAHA; Ben D.
McCallister, MD, FACC, FAHA; Aryan N. Mooss, MBBS, FACC, FAHA;
Michael G. O'Reilly, MD, FACC; William L. Winters, Jr, MD,
FACC, FAHA
Task
Force Members
Raymond
J. Gibbons, MD, FACC, FAHA, Chair; Elliott M. Antman, MD,
FACC, FAHA, Vice Chair; Joseph S. Alpert, MD, FACC, FAHA;
David P. Faxon, MD, FACC, FAHA; Valentin Fuster, MD, PhD,
FACC, FAHA; Gabriel Gregoratos, MD, FACC, FAHA; Loren F. Hiratzka,
MD, FACC, FAHA; Alice K. Jacobs, MD, FACC, FAHA; Richard O.
Russell, MD, FACC, FAHA*; Sidney C. Smith, Jr, MD, FACC, FAHA
Table
of Contents:
Preamble
-
Introduction
- Exercise
Testing Procedure
- General
Overview
- Indications
and Safety
- Equipment
and Protocols
- Exercise
End Points
- Interpretation
of the Exercise Test
- Cost
and Availability
- Clinical
Context
- Exercise
Testing to Diagnose Obstructive Coronary Artery Disease
- Rationale
- Pretest
Probability
- Diagnostic
Characteristics and Test Performance
- Believability
Criteria for Diagnostic Tests
- Diagnostic
Accuracy of the Standard Exercise Test
- Cofounders
of Stress ECG Interpretation (Modification
I)
- Digoxin
- Left
Ventricular Hypertrophy With Repolarization Abnormalities
- Resting
ST Depression
- Left
Bundle-Branch Block
- Right
Bundle-Branch Block
- ST-Segment
Interpretation Issues
- Risk
Assessment and Prognosis in Patients With Symptoms or a
Prior History of Coronary Artery Disease
- Risk
Stratification: General Considerations
- Prognosis
of Coronary Artery Disease: General Considerations
- Risk
Stratification With the Exercise Test (Modifications
II, III,
IV)
- Use
of Exercise Test Results in Patient Treatment
- After
Myocardial Infarction (Modification
V)
- Exercise
Test Logistics
- Risk
Stratification and Prognosis
- Activity
Counseling
- Cardiac
Rehabilitation
- Summary
- Exercise
Testing Using Ventilatory Gas Analysis
- Special
Groups: Women, Asymptomatic Individuals, and Postrevascularization
Patients
- Women
- Diagnosis
of Coronary Artery Disease in the Elderly
- Exercise
Testing in Asymptomatic Individuals Without Known CAD
(Modifications
VI, VII)
- Valvular
Heart Disease (Modification
VIII)
- Exercise
Testing Before and After Revascularization
- Investigation
of Heart Rhythm Disorders (Modification
IX)
- Evaluation
of Hypertension
(Modification X)
- Pediatric
Testing: Exercise Testing in Children and Adolescents
- Differences
Between Pediatric and Adult Testing
- Exercise
Testing for Specific Pediatric and Congenital Cardiac
Problems
The
ACC/AHA Task Force on Practice Guidelines makes every effort
to avoid any actual or potential coflicts of interest that might
arise as a result of an outside relationship or personal interest
of a member of the writing panel. Specifically, all members
of the writing panel are asked to provide disclosure statements
of all such relationships that might be perceived as real or
potential conflicts of interest. These statements are reviewed
by the parent task force, reported orally to all members of
the writing panel at the first meeting, and updated as changes
occur.
This
document was approved by the American College of Cardiology
Board of Trustees in July 2002 and by the American Heart Association
Science Advisory and Coordinating Committee in June 2002.
When
citing this document, the American College of Cardiology Foundation
and the American Heart Association request the following citation
format be used: Gibbons RJ, Balady GJ, Bricker JT, Chaitman
BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss
AN, O'Reilly MG, Winters WL Jr. ACC/AHA 2002 guideline update
for exercise testing: a report of the American College of
Cardiology/American Heart Association Task Force on Practice
Guidelines (Committee on Exercise Testing). 2002. American
College of Cardiology Web site. Available at: www.acc.org/clinical/guidelines/exercise/dirIndex.htm.
This
document is available on the World Wide Web sites of the American
College of Cardiology (www.acc.org) and the American Heart
Association (www.americanheart.org). Copies of this document
(the complete guidelines) are available for $10 each by calling
800-253-4636 (US only) or writing the American College of
Cardiology Resource Center, 9111 Old Georgetown Road, Bethesda,
MD 20814-1699 (ask for No. 71-0231). To obtain a reprint of
the shorter version (executive summary describing the changes
to the guidelines) planned for subsequent publication in the
Journal of the American College of Cardiology and Circulation,
ask for reprint No. 71-0232. To purchase additional reprints
(specify version and reprint number): up to 999 copies, call
800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies,
call 214-706-1789, fax 214-691-6342, or email pubauth@heart.org.
*
Former Task Force member during this writing effort.
©
2002 by the American College of Cardiology Foundation and
the American Heart Association, Inc.
|
