Exercise testing: do frequent premature ventricular depolarizations represent a new criterion of positivity?

Exercise testing is widely used to detect coronary heart disease in patients with suspected ischaemic cardiomyopathy, but also in apparently healthy persons, for example before the initiation of sport activity. Exercise testing is also used to assess shortand long-term prognosis. The only current criterion for positivity of the exercise test is an ischaemic ST-segment response to exercise, that has been proven to be a powerful predictor of major coronary events, including death. In contrast, the occurrence of premature ventricular depolarizations during exercise has been generally considered as noninformative. The long-term prognostic implications of exercise-induced premature ventricular depolarizations have been debated in patients with known or suspected cardiovascular disease. In apparently healthy subjects, the occurrence of premature ventricular depolarizations during exercise was not associated with an increase in cardiovascular mortality and was reported to be a normal response of a normal heart during exercise.