Two cases of exercise-related arrhythmia: hemodynamic correlates and short-term response to bisoprolol

Exercise-related arrhythmia is attracting growing attention, according to the increased popularity of leisure-time sports, which have great benefits and acute risk, although the hemodynamics and therapeutics of exercise-related arrhythmia are poorly understood. We have experienced two cases of different types of exercise-related arrhythmias. In an 80-year-old woman, exercise-induced increase in supraventricular premature contractions (SVPCs) converted to atrial fibrillation (AF) during a control ergometric stress test (EST), but SVPCs were diminished, and AF was not observed in the secondary EST after starting bisoprolol. In a 39-year-old woman, idiopathic premature ventricular contractions (PVCs) appeared immediately after the termination of the control EST but were scarcely induced by the secondary EST under the treatment with bisoprolol. Post-exercise abnormal increase in the double product was suppressed, leading to the possibility of improved exercise tolerance in both cases. A couple of ESTs under the same protocol to compare the arrhythmic behaviors with and without treatment provides a therapeutic strategy in exercise-related arrhythmia, and short-term bisoprolol is concluded to be favorable to the specific types of exercise-related arrhythmia, at least in these two cases.