Chronotropic incompetence could negatively influence post-operative risk assessment in patients before lung cancer surgery

Chronotropic incompetence (CI) is broadly defined as the inability of the heart to increase its rate commensurate with increased activity or demand (1). The traditional equation used to predict maximal heart rate (HR) is 220 beats/minute – age (2,3). The definition of CI is not standardized among literature, though according to most definitions it is diagnosed when, during an incremental dynamic exercise test, HR fails to reach an arbitrary percentage (85%, 80% or less commonly 70%) of the age-predicted maximal HR (4-6)