SAFETY OF DOBUTAMINE STRESS ECHOCARDIOGRAPHY SUPERVISED BY REGISTEREDNURSE SONOGRAPHERS

Dobutamine stress echocardiography (DSE) is widely used for the diagno sis and evaluation of coronary artery disease. Studies examining the s afety of this technique typically have involved DSE supervised by phys icians. At the Mayo Clinic, experienced registered nurse (RN) sonograp hers were trained to perform DSE under the direct supervision of a phy sician. To prove that the safety of DSE was not compromised with the c hange in supervision, we examined data from 1035 consecutive outpatien t studies: 516 patients were monitored by cardiologists or cardiology fellows (group 1) and 519 were monitored by trained RN sonographers (g roup 2), Risk factors, history of coronary artery disease, stress para meters, and complication rates were similar in both groups. In group 1 , one patient experienced sustained ventricular tachycardia requiring treatment. In group 2, one patient experienced ventricular fibrillatio n during recovery and was successfully resuscitated. Outpatient DSE is safe when supervised by RN sonographers.