title: Detection of myocardial ischemia with a computer-assisted 12-lead 24-hour ECG monitoring system (EAGLE) in patients with suspected unstable angina.
abstract: This study was undertaken to evaluate the diagnostic value of a new device, the 'EAGLE' computer-assisted multiple-lead long-term electrocardiography (ECG) monitoring and analyzing system, in patients with suspected unstable angina, and to compare the results with the Holter monitor. A total of 101 patients with a history of suspected unstable angina underwent a simultaneous 24-h examination with the EAGLE and 2-channel Holter monitors. The diagnosis of unstable angina was established in 70 patients: 41 had significant organic stenosis, and 29 had coronary spasm. Ischemic ST deviations were detected 229 times in 44 patients (62.9%) with the EAGLE system and 101 times in 20 patients (28.6%) with the Holter monitor. The sensitivity of myocardial ischemia in unstable angina with the EAGLE system was significantly higher than that with Holter monitor (62.9 vs 28.6%, p<0.05). The difference of sensitivity was due mainly to the low detection rate of the Holter monitor for asymptomatic myocardial ischemia (EAGLE vs Holter; 187 times vs 72 times) and myocardial ischemia in the infero-posterior area in patients with organic stenosis (30 times vs none). It is concluded that the EAGLE system is a sensitive tool for the diagnosis of unstable angina in patients without significant ECG changes, and an excellent tool for evaluating silent myocardial ischemia or myocardial ischemia of the infero-posterior area.
authors.affiliation: Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Shimada
authors.forename: Y
authors.initials: Y
authors.lastname: Hirota
authors.forename: H
authors.initials: H
authors.lastname: Onaka
authors.forename: T
authors.initials: T
authors.lastname: Mishima
authors.forename: S
authors.initials: S
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
authors.forename: Y
authors.initials: Y
authors.lastname: Kita
authors.forename: K
authors.initials: K
authors.lastname: Kawamura
mesh_terms: D000789:Angina, Unstable / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory / Q000379:methods; D001330:Electronic Data Processing; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology