Silent myocardial ischaemia in Holter monitoring and exercise stress testing after a first myocardial infarction

Silent ischaemic ST segment depression and heart rate changes during ambulatory 24 h electrocardiography and bicycle exercise stress testing were studied 8–12 weeks after the first myocardial infarction in 22 patients, aged 36–65 years (X; = 50.2). During Holter monitoring it was found that 18 patie...

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Published in:European heart journal 1988-12, Vol.9 (suppl-N), p.114-118
Main Authors: Moczurad, K. W., Grodecki, J. K., Dubiel, J. P., Curylo, A. M.
Format: Article
Language:English
Subjects:
Adult
Aged
Coronary Disease - complications
Electrocardiography
Exercise Test - adverse effects
exercise-induced ischaemia
Female
Heart Rate
Holter monitoring
Humans
Male
Middle Aged
Monitoring, Physiologic - methods
Myocardial Infarction - complications
Silent myocardial ischaemia
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container_end_page 118
container_issue suppl-N
container_start_page 114
container_title European heart journal
container_volume 9
creator Moczurad, K. W.
Grodecki, J. K.
Dubiel, J. P.
Curylo, A. M.
description Silent ischaemic ST segment depression and heart rate changes during ambulatory 24 h electrocardiography and bicycle exercise stress testing were studied 8–12 weeks after the first myocardial infarction in 22 patients, aged 36–65 years (X; = 50.2). During Holter monitoring it was found that 18 patients had 64 episodes of ST segment depression, including 27 (42.2%) symptomatic and 37 (57.8%) asymptomatic episodes. Mean maximal ST segment depression in painful and painless episodes was 3.5 ± 1.1 mm and 2.4 ± 1.2 mm(P
doi_str_mv 10.1093/eurheartj/9.suppl_N.114
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W. ; Grodecki, J. K. ; Dubiel, J. P. ; Curylo, A. M.</creator><creatorcontrib>Moczurad, K. W. ; Grodecki, J. K. ; Dubiel, J. P. ; Curylo, A. M.</creatorcontrib><description>Silent ischaemic ST segment depression and heart rate changes during ambulatory 24 h electrocardiography and bicycle exercise stress testing were studied 8–12 weeks after the first myocardial infarction in 22 patients, aged 36–65 years (X; = 50.2). During Holter monitoring it was found that 18 patients had 64 episodes of ST segment depression, including 27 (42.2%) symptomatic and 37 (57.8%) asymptomatic episodes. Mean maximal ST segment depression in painful and painless episodes was 3.5 ± 1.1 mm and 2.4 ± 1.2 mm(P&lt;0.02), respectively. The mean maximal heart rale in symptomatic and asymptomatic episodes was 112 ± 14.2 beats min−1 and 115 ± 16.8 beats min−1 (NS), respectively. No significant difference was found in the duration of symptomatic and asymptomatic episodes. Ambulatory asymptomatic episodes were most frequent between midnight and noon (63.2%). It was observed that when heart rate was below 100 beats min−1 symptomatic episodes were twice as frequent during monitoring while during exercise testing ST segment depression at this heart rate occurred only in two cases. In contrast, there were more asymptomatic episodes at heart rate above 125 beats min−1 and exercise induced ST segment depression were five times more frequent. One may conclude that silent ischaemia is a frequent phenomenon in the early period after the first myocardial infarction and asymptomatic episodes occur particularly frequently during rapid heart rate (over 125 beats min−1). 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The mean maximal heart rale in symptomatic and asymptomatic episodes was 112 ± 14.2 beats min−1 and 115 ± 16.8 beats min−1 (NS), respectively. No significant difference was found in the duration of symptomatic and asymptomatic episodes. Ambulatory asymptomatic episodes were most frequent between midnight and noon (63.2%). It was observed that when heart rate was below 100 beats min−1 symptomatic episodes were twice as frequent during monitoring while during exercise testing ST segment depression at this heart rate occurred only in two cases. In contrast, there were more asymptomatic episodes at heart rate above 125 beats min−1 and exercise induced ST segment depression were five times more frequent. One may conclude that silent ischaemia is a frequent phenomenon in the early period after the first myocardial infarction and asymptomatic episodes occur particularly frequently during rapid heart rate (over 125 beats min−1). Episodes of silent ischaemia are found more frequently during Holter monitoring than exercise stress testing.</description><subject>Adult</subject><subject>Aged</subject><subject>Coronary Disease - complications</subject><subject>Electrocardiography</subject><subject>Exercise Test - adverse effects</subject><subject>exercise-induced ischaemia</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Holter monitoring</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic - methods</subject><subject>Myocardial Infarction - complications</subject><subject>Silent myocardial ischaemia</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><recordid>eNpVkMlOwzAQhi0EgrI8AsInbimexHHiI2IrqMABEBUXy4knYMiG7Ujw9gRaVeI0h3-ZmY-QI2BTYDI5wcG9oXbh_URO_dD3tbqbAvANMoE0jiMpeLpJJgxkGgmRL3bIrvfvjLFcgNgm20nMRcyTCekfbI1toM13V2pnrK6p9eWbxsZqals66-qAjjZda0PnbPtKdWsofqErrUfqg0PvaUAf_rTq16xpZZ3_39lW2pXBdu0-2ap07fFgNffI0-XF49ksmt9fXZ-dzqMyFhCikqNhxvCYQ1xwBiwzBchcJ4bJTAIvdM50Djk3KZOFBGkYgDBFVRiTawnJHjle9vau-xzG-1QzPoZ1rVvsBq-yPONcing0Zktj6TrvHVaqd7bR7lsBU7-s1Zq1kmrFWo2sx-ThasVQNGjWuRXcUY-WuvUBv9aydh9KZEmWqtniRZ3fzm_u5PNCZckPLZiSPQ</recordid><startdate>198812</startdate><enddate>198812</enddate><creator>Moczurad, K. 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M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Silent myocardial ischaemia in Holter monitoring and exercise stress testing after a first myocardial infarction</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>1988-12</date><risdate>1988</risdate><volume>9</volume><issue>suppl-N</issue><spage>114</spage><epage>118</epage><pages>114-118</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Silent ischaemic ST segment depression and heart rate changes during ambulatory 24 h electrocardiography and bicycle exercise stress testing were studied 8–12 weeks after the first myocardial infarction in 22 patients, aged 36–65 years (X; = 50.2). During Holter monitoring it was found that 18 patients had 64 episodes of ST segment depression, including 27 (42.2%) symptomatic and 37 (57.8%) asymptomatic episodes. Mean maximal ST segment depression in painful and painless episodes was 3.5 ± 1.1 mm and 2.4 ± 1.2 mm(P&lt;0.02), respectively. The mean maximal heart rale in symptomatic and asymptomatic episodes was 112 ± 14.2 beats min−1 and 115 ± 16.8 beats min−1 (NS), respectively. No significant difference was found in the duration of symptomatic and asymptomatic episodes. Ambulatory asymptomatic episodes were most frequent between midnight and noon (63.2%). It was observed that when heart rate was below 100 beats min−1 symptomatic episodes were twice as frequent during monitoring while during exercise testing ST segment depression at this heart rate occurred only in two cases. In contrast, there were more asymptomatic episodes at heart rate above 125 beats min−1 and exercise induced ST segment depression were five times more frequent. One may conclude that silent ischaemia is a frequent phenomenon in the early period after the first myocardial infarction and asymptomatic episodes occur particularly frequently during rapid heart rate (over 125 beats min−1). Episodes of silent ischaemia are found more frequently during Holter monitoring than exercise stress testing.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>3246243</pmid><doi>10.1093/eurheartj/9.suppl_N.114</doi><tpages>5</tpages></addata></record>
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source Oxford University Press Archive
subjects Adult
Aged
Coronary Disease - complications
Electrocardiography
Exercise Test - adverse effects
exercise-induced ischaemia
Female
Heart Rate
Holter monitoring
Humans
Male
Middle Aged
Monitoring, Physiologic - methods
Myocardial Infarction - complications
Silent myocardial ischaemia
title Silent myocardial ischaemia in Holter monitoring and exercise stress testing after a first myocardial infarction
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