It was shown previously that patients prescribed with nitrates show VA less likely.5, 7, 25 It is also known that exercise can induce cardiac arrhythmias under the conditions of diuretic and digitalis therapy.7, 26 Our results supported this finding, showing more NTVA during CPET in patients prescribed with mineralocorticoid receptor blockers. The gene discussed is NR3C2; the disease is chronic obstructive pulmonary disease.