[Validation of the Holter method in detecting myocardial ischemia using an exercise test simultaneously].
To evaluate the reliability of Holter monitoring in reproducing myocardial ischemic changes, 110 patients (90 males, 20 females; age range: 14-74 years) underwent a Bruce protocol treadmill exercise test. An electrocardiogram was recorded simultaneously with a two-channel modulated Holter recorder (frequency response: 0.05-100 Hz) with bipolar CM-V3 and CM-V5 leads and by a conventional 12-lead system. An ischemic ST-segment change was defined as 1 mm or more ST-segment depression lasting more than 0.08 sec after the J point. Results were concordant in 101 patients, 36 with both positive and 65 with both negative responses. Eight false negative and one false positive Holter ischemic episodes occurred. This yielded an accuracy (expressed as sensitivity, specificity, positive and negative predictive values) of 81.8%, 98.5%, 97.3% and 89.0%, respectively. There was a good correlation between the maximal ST-segment depression (r = 0.57; p less than 0.001), duration of ischemia (r = 0.89; p less than 0.001), heart rate at the onset of the ischemic episode (r = 0.91; p less than 0.001) and maximal heart rate (r = 0.98; p less than 0.001).


CONCLUSIONS
Two-channel amplitude modulated Holter recording system with bipolar CM-V3 and CM-V5 leads can reliably reproduce ST-segment changes.
Rayo
I
I
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid.
Marín Huerta
E
E
Muela
A
A
Moro
C
C
Soler
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis*; D015716:Electrocardiography, Ambulatory; D004566:Electrodes; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors
Validación del Holter para la detección de isquemia miocárdica mediante la realización de prueba de esfuerzo simultánea.