Low reliability of ECG monitoring in CCU for detection of ischemic episodes
Biagini, A.; L'Abbate, A.; Mazzei, M.G.; Carpeggiani, C.; Testa, R.; Antonelli, R.; Michelassi, C.; Benassi, A.; Maseri, A.
Giornale Italiano di Cardiologia 10(11): 1449-1453
1980
ISSN/ISBN: 0046-5968 PMID: 7202892 Document Number: 165031
In 10 patients with frequent anginal attacks admitted to CCU, 2-lead ECG Holter monitoring (H-M) was performed for a total of 10 days. The number of ischemic episodes detected by retrospective analysis of H-M was compared with the number detected on the basis of symptoms and continuous visual ECG monitoring in CCU (CCU-M) by highly trained staff. A total of 157 episodes was identified by H-M [82 ST elevation (ST), 15 ST depression (ST) and 60 t wave changes]. Only 15 of these episodes were detected by CCU-M (13 ST, 1 ST and 1 T wave changes) of which 12 were symptomatic. When 6 H-M ECGs were simultaneously displayed on an oscilloscope in real-time (as in CCU-M), one of the Authors was able to detect only 36% of the episodes, whereas the frequency reached 80% when the analysis was limited to one tape at the time. The results show the low reliability of the CCU-M in detecting ischemic attacks; this appears mainly related to the display of multiple tracings.