Exercise testing commonly used by clinicians to characterize cardiovascular risk by detecting myocardial ischemia and assessing response to exercise. However, a consensus has not previously existed regarding the significance of exercise test-induced arrhythmias due to conflicting results from the available studies. Recent studies with longer follow-up and improved technology have therefore stim...

The ECG during peak exercise shows sinus tachycardia of 167 beats/min with pre-excitation and ischaemic-like STsegment depression in V3–V6 (Fig. 1a in the Question). The ECG in the recovery phase shows disappearance of pre-excitation with normalisation of ST segments at a heart rate of 145 beats/min (Fig. 1b in the Question). Pre-excitation reoccurred at a heart rate of 101 beats/min. The basel...

Compared to standard exercise tolerance testing, cardiopulmonary exercise testing is a reliable and powerful tool that can be used for risk stratification, exercise prescription and clinical diagnosis.