Detection of Spontaneous Episodes in Post-Infarction Angina. Comparison Between CCU and Holter Monitoring

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Abstract
The objects of this study are: (1)to evaluate the incidence of early post-infarction angina in patients who developed transmural infarction (Q-AMI) or sub-endocardial infarction (no Q-AMI) during hospitalization; (2)to compare data obtained from patients monitored in Coronary Care Unit (CCU) with those obtained from Holier monitoring. The 107 patients under study(55 with Q-AMI and 52 with no Q-AMI) presented the acute event on average 7·4 and 5·1 days after admittance in the CCU, respectively. A history of angina was present in all except I patient with Q-AMI and in all with no Q-AMI. After AMI the angina disappeared in 22 of the patients with Q-AMI and in 31 with no Q-AMI, while it continued in 33 and 21 of these patients, respectively. Twenty-one patients underwent ECG recording according to the Holter technique while in CCU, for an average of 4·4 days before and 5·2 days after the onset of AMI. The comparative analysis of the results obtained from the CCU and from Holter monitoring shows that the CCU greatly underestimates the number of ischaemic episodes, even when pain is present (4·5 episodes per patient per day before AMI and 2 after, versus 13·7 and 6·8 with holter monitoring). The number of ventricular arrhythmias also seemed lower when analysing data from CCU monitoring. These data demonstrate the importance of Holter monitoring, even in patients admitted to a CCU, for a precise evaluation of the ischaemic and arrhythmic phanomena.

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