Trending Away From Treadmill

Recumbent bike stress test enables UConn Health cardiologists to see optimal images of the heart.

Demonstration of seated stress test with echocardiogram

Dr. Kai Chen (standing), with a model patient (cardiology nurse Bob Santopietro), and cardiac sonographer Lekha Srikanthan (foreground) demonstrate an exercise stress test using a recumbent bike instead of a treadmill in the Pat and Jim Calhoun Cardiology Center at UConn Health on January 15, 2019. (Tina Encarnacion/UConn Health photo)

Some patients who go to the Pat and Jim Calhoun Cardiology Center at UConn Health for a stress test are skipping the treadmill and instead using a recumbent bike to elevate their heart rate.

This provides a better option for those who have physical or health limitations that make the treadmill’s speed and incline unsafe. While the seated approach to stress testing isn’t new, the recumbent bike in the Calhoun Cardiology Center builds on the concept, leading to an advantage that is new.

Dr. Kai Chen
Listen to Dr. Kai Chen discuss the seated stress test in this UConn Health Minute on Connecticut Public Radio. (Photo by Peter Morenus)

“Because patients can exercise on this bike and at the same time maintain a reclining position, we’re able to do an echocardiogram simultaneously to evaluate how well the heart works and pumps blood,” says Dr. Kai Chen, whose specialties include cardiovascular imaging. “We can get a lot of information from this test.”

The echocardiogram provides ultrasound images of the heart, enabling doctors to analyze the heart’s structure and effectiveness. To get the truest picture, the goal is to measure this during the target heart rate, which is 85 percent of maximum predicted heart rate.

What makes the simultaneous echocardiogram so beneficial is it can be done in real time. The upper body needs to be still in order to yield visible results. With the treadmill, the patient has to stop running and move from the machine to the bed before the echocardiogram can start. And while it usually only takes 10 to 15 seconds to make that transition, it’s still enough time for a target heart rate of 150 beats per minute to drop to 110.

“We’ll get a lot of valuable information on how your heart is working when it’s beating fast, under stress,” Chen says. “We would not worry about your heart rate slowing down because you had to get off the treadmill in order to get the echocardiogram. We also can measure the pressures inside of the heart in different chambers to give you a lot more information on what part of the heart is not working well, because we’re using the ultrasound at the same time as you’re exercising.”

Images of a heart with an elevated heart rate still can reveal valuable information, but those taken at peak stress levels – during, not after, rigorous exercise – are the most telling.

More information about the Pat and Jim Calhoun Cardiology Center at UConn Health is available at health.uconn.edu/cardiology, or call 860-679-3343 for an appointment.