Table 3 .

Criteria for terminating a CPET in children.

1 Clinical

Symptoms – chest pain, severe headache, dizziness, chills, sustained nausea, inappropriate dyspnoea Signs – sustained pallor, clammy skin, disorientation, inappropriate affect Patient requests termination of the study

2 ECG

Failure of heart rate to increase with exercise, and extreme fatigue, dizziness, or other symptoms suggestive of insufficient cardiac output Premature ventricular contractions (PVCs) with increasing frequency Ventricular tachycardia (run of >3 PVCs) Supraventricular tachycardia ST segmental depression, or elevation, of more than 3 mm Triggering of atrioventricular (AV) block (2nd degree AVblock type Mobitz or 3rd degree AV block) by exercise Triggering of QTc lengthening >500 ms

3 Blood pressure

Excessive levels (age-dependent) – systolic blood pressure 250 mmHg, diastolic blood pressure 125 mmHg Progressive fall in systolic blood pressure with increasing workload

4 Progressive fall in oxygen saturation to <90% or a 10-point drop from resting saturation in a symptomatic patient.

Modified from Paridon et al. and Bar-Or.^27,44