Incidence of myocardial ischemia in patients with ischemic heart disease tested with 48-hour Holter monitoring
Negrusz-Kawecka, M.; Kobusiak-Prokopowicz, M.; Sobotkiewicz-Cyran, S.; Cyran, K.
Polski Merkuriusz Lekarski Organ Polskiego Towarzystwa Lekarskiego 9(50): 528-530
2000
ISSN/ISBN: 1426-9686 PMID: 11081316 Document Number: 521626
The aim of the work was to examine the frequency, duration and times of occurrence of painful and painless episodes of heart muscle ischaemia in patients suffering from ischaemic heart disease as well as to evaluate its variations during 24-hour period. Out of all 30 subjects, altogether 104 episodes of myocardial ischaemia were recorded in 18 patients. 67 episodes (in 16 patients) were recorded in the first 24-hour period, and 37 episodes (11 patients) were recorded in the second 24-hour period. 7 patients revealed the incidence of episodes only during the first 24-hour period and 2 patients recorded episodes only in the second 24-hour period. Out of 9 patients in whom ischaemic episodes were observed both in the first as well as in the second 24-hour period, more episodes occurred in the first 24-hour period in 5 patients, more episodes in the second 24-hour period were observed in 3 patients and the same number of episodes in both 24-hour periods was observed in 1 subject. Average duration of the episode was significantly longer in the first 24-hour period. Characteristic 24-hour distribution of ischaemic episodes was observed with peak incidence between 6.00:8.00, 8.00:10.00 and between 18.00:20.00. The times of occurrence of ischaemic episodes on 24-hour monitoring resemble these registered on 48-hour monitoring. Differences in occurrence of ischaemic episodes between first and second 24-hour period were observed, but they reached the level of statistical significance only in the time of their peak incidence, between 8.00 and 10.00 a.m. and 18.00 and 20.00 (p < 0.05). Characteristic pattern of distribution of the episodes of myocardial ischaemia was observed. The number of episodes of myocardial ischaemia is higher in the first 24-hour period of monitoring, although the level of statistical significance was achieved only for episodes occurring between 8.00:10.00 and 18.00:20.00. Duration of ischaemic episodes on 48-hour Holter monitoring is statistically significantly longer during the first 24-hours of monitoring. Majority of ischaemic episodes are painless.