Cardiac response to upper gastrointestinal endoscopy.

In 54 subjects, cardiac function was investigated during upper gastrointestinal endoscopy with a Holter electrocardiorecorder. The heart rate of patients who were premedicated with an anticholinergic agent increased more than did that of patients who received no premedication. In the group who received no anticholinergic premedication, sinus tachycardia was evident during endoscopy, but the only clinically important change was in one patient who converted to atrial flutter from atrial fibrillation. The heart rate increased during endoscopy among patients undergoing the procedure for the first time, but it did not increase in the patients who had previously undergone endoscopy. These results show that endoscopy is a relatively safe examination from the view point of cardiac risk when performed without the administration of an anticholinergic agent, but that cardiac patients should be monitored carefully. The endoscopist should also take into consideration the psychological state of the examinees.