Cardiac arrhythmias associated with treadmill claudication testing

Eighty-one consecutive patients of an average age of 58 years with suspected lower limb arterial disease underwent standard 5-minute treadmill claudication testing. Prior to, during, and after testing the patients were monitored electrocardiographically. The number of electrocardiographic abnormalities seen in 81 patients undergoing study increased from 33 (40.6%) at rest to 49 (60.5%) with exercise. The commonest abnormalities encountered with exercise were the development and increased incidence of paroxysmal beats and ST-T wave changes which, in some instances, became life-threatening, aborting the test. Since the principal hazard for patients with claudication appears to derive from an increase propensity to cardiac mortality and morbidity, rather than from the consequences of impaired circulation to the limb, electrocardiographic monitoring during treadmill claudication testing, though little practiced, is strongly advised.