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ISCHEMIA ON HOLTER MONITORING PREDICTS POST-MI MORTALITY.

Two-lead Holter monitoring for detecting silent and symptomatic ischemia is an emerging technology. In this study, it helped predict mortality among 103 postinfarction patients who had congestive heart failure, or high grade arrhythmias, or both.

In this high-risk population, 30 patients had detectable ischemic episodes, most of which were silent. After one year, nine (30 percent) of these 30 patients had died, whereas only eight (11 percent) of the 73 patients who did not have ischemic episodes died. Multivariate analysis suggests that Holter monitoring provided additional information beyond what was otherwise available, particularly for the large group of patients who could not undergo exercise testing.

While the authors emphasize the importance of silent ischemia, this report is more impressive because it shows the usefulness of Holter monitoring in patients who cannot undergo standard exercise testing.

— THL

Published in Journal Watch General Medicine February 26, 1988

Citation(s):

Gottlieb S O; Gottlieb S H; Achuff S C et al. Silent ischemia on Holter monitoring predicts mortality in high-risk postinfarction patients. JAMA 1988 Feb 19 259 1030-1035.

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