Early Exercise Tests after Uncomplicated Acute Myocardial Infarction before Early Discharge from Hospital

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Abstract
As part of an early mobilization and early discharge scheme, 76 consecutive low-risk patients were selected from a population of 298 acute myocardial infarction (AMI) patients, to undergo an exercise test. The test was done on the 7th day after an AMI. The patients were 57 men and 19 women of mean age 57 and 68 yr, respectively. Twelve patients were unable to complete the test, but no serious complications were observed. Average heart rate during the highest exercise load (50 W) was 106 beats/min. The following risk indices (RI) were considered abnormal and were looked for during or after exercise: heart rate > 125 (n = 12), major ventricular arrhythmias (n = 3), angina pectoris (n = 9) and ST deviation of > 1 mm (n = 11). Two RI were found in 9 patients during the exercise test which led to prolonged hospitalization. One RI was found in 26 patients (34%). Of the patients with normal exercise test, 88% (n = 36) had an uneventful recovery during the 6 mo. observation period in contrast to 35% (n = 9) of patients with 1 RI (P < 0.05). Only 2 of the patients with heart rate < 125 recovered normally, a significantly lower number (P < 0.05) than among patients with a normal exercise test. Reinfarction occurred in 1 patient with normal exercise test and in 6 (23%) of those with 1 RI (P < 0.01) and 2 of those with 2 RI (NS [not significant]). A submaximal bicycle exericise test seven days after an AMI is a safe and useful selection instrument for early discharge from hospital as well as a useful predicting instrument of future complications.