Early chronotropic incompetence predicts the need for atropine during dobutamine stress echocardiography.

Analysis of heart rate responses in 130 patients undergoing dobutamine stress echocardiography revealed that heart rate response at 20 microg/kg/min predicted the eventual need for atropine in chronotropically incompetent patients. Administering atropine at intermediate doses of dobutamine rather than at peak stress may reduce test duration and provide a more balanced chronotropic and inotropic stress.