National survey of exercise stress testing facilities

This report surveys the method, volume, protocol, criteria for a positive test, and complications of 518,448 exercise stress tests at 1,375 centers. Exercise test capacity was estimated at 2,147,450. An even distribution of bicycle, Master and treadmill testing was seen by regions within the country. The majority were using the Bruce protocol. The S-T segment depression of .5 mm was considered positive by 4.6 percent; 1.0 mm by 75.4 percent; 1.5 mm by 14.0 percent, and 2.0 mm or greater by 11.9 percent of the centers. Complications were 3.58 infarctions, 4.78 serious arrhythmias, and 0.5 deaths per 10,000 tests. Total of all complications was 8.86 per 10,000 tests. We conclude that exercise stress testing has increased with office-based testing undergoing the greatest expansion. This has been associated with few complications and greater safety.