The relationship between ST segment deviation projected to the front of the chest during exercise and simultaneous Holter monitoring

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Abstract

Simultaneous two-channel Holter monitoring, with a direct recording system, and maximal exercise testing with a 12-lead precordial electrocardiographic mapping system were performed in 50 patients with chest pain (41 with documented coronary artery disease, 9 without). The exploring Holter leads were placed to correspond to CM5 and an aVF-like lead. In 36 patients, ST segment changes were found with both Holter and the 12-lead precordial electrocardiogram, while in 12 patients no ischaemic changes were detected by either method. Thus the results of the two methods concurred in 48 of 50 patient (96%). The magnitude of the ischaemic change was similar in 24 of 36 patients (67%), while the Holter system underestimated the ischaemic change by 0.5-2.0 mm in 12 patients. When the maximal ST segment deviation in V5 was compared with CM5, the deviations with both systems were identical in all but one patient in whom a difference of 0.5 mm was found. The use of a Holter lead resembling a VF identified maximal ST segment change on only one occasion, and in only four patients was an ST segment change of 1 mm noted. In conclusion, ambulatory monitoring utilizing only CM5 seems to detect most episodes with ST segment changes, but the use of a 12-lead precordial mapping system during exercise testing may expand the possibility of defining the optimal sites for the exploring Holter leads to detect maximal ST segment change.

Original languageEnglish
JournalEuropean Heart Journal
Volume9
Issue number4
Pages (from-to)412-7
Number of pages6
ISSN0195-668X
Publication statusPublished - Apr 1988

Keywords

  • Adult
  • Aged
  • Coronary Vessels
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Physical Exertion
  • Journal Article
  • Research Support, Non-U.S. Gov't

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