Kardiologie up2date 2012; 08(04): 278-281
DOI: 10.1055/s-0032-1325922
Hotline – Koronare Herzerkrankung und Atherosklerose
© Georg Thieme Verlag KG Stuttgart · New York

Belastungsuntersuchungen und negative Chronotropie

Ralf Ewert
Christian Opitz
Beate Koch
Christoph Schäper
Sven Gläser
Further Information

Publication History

Publication Date:
20 December 2012 (online)


Chronotropic incompetence (CI) describes the inability of the heart to adequately increase its rate in response to increased activity or demand. Chronotropic incompetence is common in patients with cardiovascular disease, produces exercise intolerance, impairs quality of life, and is an independent predictor of major adverse cardiovascular events and overall mortality. The diagnosis of CI should take into account the confounding effects of aging, physical condition, and medications but can be achieved objectively with the use of widely available exercise testing methods and standardized definitions. The prognostic information of CI remains preserved in patients treated with β-Blockers. Therefore, the use of separate CI criteria for these patients does not appear necessary. The role of rate-adaptive pacing in patients with CI remains to be determined, although this technique showed promising results in small studies and individual patients. In addition, exercise training can reduce the extent of CI in patients with heart failure and thereby improve functional capacity and symptomatic state.