Abolition of Holter monitor-detected silent myocardial ischemia after percutaneous transluminal coronary angioplasty.
Twenty-four hour Holter ambulatory electrocardiographic recordings were obtained before and after successful coronary angioplasty in 36 patients. Twenty-five patients had one vessel, 10 had two vessel and 1 had three vessel coronary artery disease. Holter monitor-detected myocardial ischemia, defined as ST segment depression or elevation greater than or equal to 1 mm, was present in 10 patients (28%). These 10 patients had a total of 39 ischemic episodes of 3 to 144 minutes' duration, with a total cumulative duration of 398 minutes. None of the 10 had Holter monitor-detected ischemia after successful angioplasty (p less than 0.01). Treadmill exercise duration increased by 29% after coronary angioplasty (p less than 0.01), and peak exercise heart rate-systolic blood pressure product increased by 27% (p less than 0.01). Thus, Holter monitor-detected myocardial ischemia is a relatively uncommon finding in patients with predominant single vessel coronary artery disease undergoing coronary angioplasty. When such ischemia is present, it is eliminated by successful coronary angioplasty.
D000328:Adult; D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon; D003251:Constriction, Pathologic; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D006321:Heart / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D005082:Physical Exertion