A Study of Pre-Discharge Holter Monitoring in Patients of Acute Myocardial Infarction
Abstract
Background: Increasing array of medical intervention available to modify the likelihood of developing recurrent episode of myocardial ischemia, it is important to identify patients of risk of provocable myocardial ischemia before discharge.
Material Methods: It was a cross-sectional study carried out in a tertiary care hospital of central India, during July 2012 to October 2014. During the monitoring period, the patient was once subjected for 100-meter brisk walk.
Result: Out of 64 cases, 6 (9.5%) cases developed ischemia during Holter, in male it was 5(10.2%) while in female it was 1(6.67%). 13.33% of cases with tobacco consumption developed ischemia on Holter monitoring and this was found to statistically significant (x2 = 5.36, p<0.05).
Conclusion: After acute myocardial infarction, pre-discharge Holter monitoring (including brisk walk) is a good non-invasive method to detect ischemia in high risk patients (like consuming tobacco in any form).
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References
2. Bigger JT Jr, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation. 1984 Feb; 69(2):250-8. [PubMed]
3. Taylor G, Humphries JO, Pitt B, Griffith LSC. Predictors of clinical course coronary anatomy and left ventricular function after recory from acute myocardial infarction. Circulation 1980; 62: 960-970.
4. Multicentric Post Infarction Research group. Risk stratification and survival after acute myocardial infarction. New Eng J Med 1983;309: 331-336.
5. Jereczek M, Dietrich A and Joahchim S. Prognostic value of ischemia during Holter monitoring and exercise testing after acute myocardial infarction. Am J Cardiol 1993; 72:8-13. [PubMed]
6. Deanfield JE, Maseri A, Selwyn AP And Morgan M. Myocardial ischemia during daily life in patients with stable angina: its relation to symptoms and heart rate change. Lancet 1983; 2:753-758. [PubMed]
7. Tzivoni D, Gavish A Zin D, Gottlieb S and Morel M. Prognostic significance of ischemia episodes in patients with previous myocardial infarction. Am J Cardiol 1988; 62: 661-664.
8. Mickley H. Editorial: Amulatory ST segment monitoring after myocardial infarction. Br Heart J 1994; 71: 113-114. [PubMed]
9. Arstall MA, Barromer FA, Horonitz JD. Silent ischemia after uncomplicated myocardial infarction: lack of clinical significance. Int. J. Cardiol 1994; 45 : 45. [PubMed]
10. Currie P, Ashby D, Saltissi S. Prognostic significance of transient myocardial infarction on ambulatory monitoring after acute myocardial infarction. Am. J. Cardiol 1993; 71: 773-777.
11. Chaitman B, McMohan RP, Terin M. Impact of treatment strategy on predischarge exercise test to the thromolysis in myocardial infarction. (TIMI) II Trial. Am. J. Cardiol 1993; 71: 131-138. [PubMed]
12. Gottlieb SO, Weisfeldt ML, Ouyang P, Mellitis ED. Silent ischemia predict infarction and death during 2 years follow up of unstable angina. J. Am. Coll. Cardiol 1987; 10: 756-760.
13. John BG, Cairns JA, Roberts M. Prognostic importance of myocardial ischemia detected by ambulatory monitoring early after acute myocardial infarction: India. New Eng. J. Med. 1996; 334: 65-71.
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