ST Segment Analysis by Holter Monitoring:

Background: There has been a renewed interest in ST segment analysis by Holter Monitoring, especially in multicenter clinical trials, but consensus on how to define an ischemic event is missing. We conducted a survey of European and U.S. publications involving ST segment analysis by Holter monitoring from 1975 to 2002 and found no notation of any correction for baseline ST segment depression in 52% of them. In 45% J‐point depression was required in addition to ST segment depression measured either 60 ms (24%) or 80 ms (76%) after the J point. In 28% ST segment elevations were included.

[1]  M. Condorelli,et al.  Asymptomatic transient ST changes during ambulatory ECG monitoring in diabetic patients. , 1985, American heart journal.

[2]  D. Tzivoni,et al.  Comparison of exercise tests and 24-hour ambulatory electrocardiographic monitoring in detection of ST-T changes. , 1974, British heart journal.

[3]  S. Themistoclakis,et al.  Characterization and prognostic significance of silent myocardial ischemia on predischarge electrocardiographic monitoring in unselected patients with myocardial infarction. , 1992, The American journal of cardiology.

[4]  A. Quyyumi,et al.  Ambulatory electrocardiographic ST segment changes in healthy volunteers. , 1983, British heart journal.

[5]  S. Homan,et al.  Relation of silent myocardial ischemia after coronary artery bypass grafting to angiographic completeness of revascularization and long-term prognosis. , 1990, The American journal of cardiology.

[6]  H Völler,et al.  Transient ST segment depression during Holter monitoring: how to avoid false positive findings. , 1992, American heart journal.

[7]  F. D. Stott,et al.  Myocardial ischaemia in patients with frequent angina pectoris. , 1979, British medical journal.

[8]  V. Froelicher,et al.  Exercise standards. A statement for healthcare professionals from the American Heart Association. Writing Group. , 1995, Circulation.

[9]  P. Ouyang,et al.  Frequency and importance of silent myocardial ischemia identified with ambulatory electrocardiographic monitoring in the early in-hospital period after acute myocardial infarction. , 1990, The American journal of cardiology.

[10]  H. Crijns,et al.  Reduction of transient myocardial ischemia with pravastatin in addition to the conventional treatment in patients with angina pectoris. REGRESS Study Group. , 1996, Circulation.

[11]  M. Mizutani,et al.  ST monitoring for myocardial ischemia during and after coronary angioplasty. , 1990, The American journal of cardiology.

[12]  J. Alpert,et al.  ACC/AHA guidelines for ambulatory electrocardiography: executive summary and recommendations. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to revise the guidelines for ambulatory electrocardiography). , 1999, Circulation.

[13]  F. D. Stott,et al.  Ambulatory ST segment monitoring. Problems, pitfalls, solutions, and clinical application. , 1980, British heart journal.

[14]  D. Tzivoni,et al.  Diagnostic Accuracy of Ambulatory ECG Monitoring in Ischemic Heart Disease , 1975, Circulation.

[15]  M. Okajima,et al.  Atrial T(Ta) wave and atrial gradient in patients with A-V block. , 1976, American heart journal.

[16]  E. Cook,et al.  Correlation Between Preoperative Ischemia and Major Cardiac Events After Peripheral Vascular Surgery , 1989, The New England journal of medicine.

[17]  C C NORLAND,et al.  ANGINA PECTORIS AND ARRHYTHMIAS DOCUMENTED BY CARDIAC TELEMETRY. , 1964, JAMA.

[18]  H. Bøtker,et al.  Impact of daily life myocardial ischemia in patients with chronic reversible and irreversible myocardial dysfunction. , 2002, The American journal of cardiology.

[19]  P. Ganz,et al.  Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease. , 1997, Circulation.

[20]  Norman J. Holter,et al.  New Method for Heart Studies , 1961, Science.

[21]  M. Proschan,et al.  Asymptomatic Cardiac Ischemia Pilot (ACIP) Study. Relationship between exercise-induced and ambulatory ischemia in patients with stable coronary disease. , 1996, Circulation.

[22]  P. Stone,et al.  Morning Increase in Ambulatory Ischemia in Patients With Stable Coronary Artery Disease: Importance of Physical Activity and Increased Cardiac Demand , 1994, Circulation.

[23]  L. Gettes,et al.  Painless ST-segment depression in patients with angina pectoris. Correlation with daily activities and cigarette smoking. , 1976, Chest.

[24]  C. Marchesi,et al.  Computer system for analysis of ST segment changes on 24 hour Holter monitor tapes: comparison with other available systems. , 1984, Journal of the American College of Cardiology.

[25]  R. O'rourke,et al.  Limitations of continuous ambulatory electrocardiogram monitoring for detecting coronary artery disease. , 1978, Annals of internal medicine.

[26]  E. Raftery,et al.  Simultaneous recording of continuous arterial pressure, heart rate, and ST segment in ambulant patients with stable angina pectoris. , 1983, British heart journal.

[27]  E. Nabel,et al.  Variability of transient myocardial ischemia in ambulatory patients with coronary artery disease. , 1988, Circulation.

[28]  D. Tzivoni,et al.  Assessment of ischemic changes by ambulatory ECG-monitoring: comparison with 12-lead ECG during exercise testing. , 1997, Journal of electrocardiology.

[29]  M. Cohen,et al.  Low molecular weight heparin decreases rebound ischemia in unstable angina or non-Q-wave myocardial infarction: the Canadian ESSENCE ST segment monitoring substudy. , 2000, Journal of the American College of Cardiology.

[30]  Ralph J. Verdino,et al.  Changes in heart rate and heart rate variability before ambulatory ischemic events , 2001 .

[31]  C. Pepine,et al.  Transient asymptomatic S-T segment depression during daily activity. , 1977, The American journal of cardiology.

[32]  V. Froelicher,et al.  Exercise standards. A statement for healthcare professionals from the American Heart Association. Writing Group. , 1995, Circulation.

[33]  S. Hinds,et al.  Identification of false positive exercise tests with use of electrocardiographic criteria: a possible role for atrial repolarization waves. , 1991, Journal of the American College of Cardiology.

[34]  J Keegan,et al.  Ischemia in the ambulatory setting--the total ischemic burden: relation to exercise testing and investigative and therapeutic implications. , 1989, Journal of the American College of Cardiology.

[35]  S. Saltissi,et al.  Prognostic value of ambulatory ST segment monitoring compared with exercise testing at 1-3 months after acute myocardial infarction. , 1994, European heart journal.

[36]  J. Deanfield,et al.  Analysis of ST-segment changes in normal subjects: implications for ambulatory monitoring in angina pectoris. , 1984, The American journal of cardiology.

[37]  P. Deedwania,et al.  Anti-ischemic effects of atenolol versus nifedipine in patients with coronary artery disease and ambulatory silent ischemia. , 1991, Journal of the American College of Cardiology.

[38]  J. Kupersmith,et al.  Silent ST segment deviations and extent of coronary artery disease. , 1980, American heart journal.

[39]  G. Guiraudon,et al.  Sinus node-atrioventricular node isolation: long-term results with the "corridor" operation for atrial fibrillation. , 1991, Journal of the American College of Cardiology.

[40]  V. Rasmussen,et al.  ST-segment deviation during 24-hour ambulatory electrocardiographic monitoring and exercise stress test in healthy male subjects 51 to 75 years of age: the Copenhagen City Heart Study. , 1999, American heart journal.

[41]  D. Wood,et al.  Characteristics and clinical significance of ambulatory myocardial ischemia in men and women in the general population presenting with angina pectoris. , 1994, Journal of the American College of Cardiology.

[42]  C. Held,et al.  Ischaemia during exercise and ambulatory monitoring in patients with stable angina pectoris and healthy controls. Gender differences and relationships to catecholamines. , 1998, European heart journal.

[43]  P. Armstrong,et al.  Pathophysiology and prognostic significance of Holter-detected ST segment depression after myocardial infarction. The Tissue Plasminogen Activator: Toronto (TPAT) Study Group. , 1992, Journal of the American College of Cardiology.