What is the clinical evidence from this study?

Study design: Observational. Population: variant angina (n=26). Intervention: ST-segment elevation episodes. Primary outcome: Diurnal distribution of ST-segment elevation and incidence of arrhythmias.

What question did this study set out to answer?

To evaluate the diurnal pattern of ST-segment elevation in relation to chest pain and assess the incidence and timing of associated cardiac arrhythmias in patients with variant angina.

May 1, 1983CirculationOpen Access

Diurnal distribution of ST-segment elevation and related arrhythmias in patients with variant angina: a study by ambulatory ECG monitoring.

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Key result

In patients with variant angina, ST-segment elevations predominantly occurred early morning (72% between 0:00 and 9:00) and were mostly asymptomatic (79%), with arrhythmias common during reperfusion.

Key Points

To evaluate the diurnal pattern of ST-segment elevation in relation to chest pain and assess the incidence and timing of associated cardiac arrhythmias in patients with variant angina.
Continuous 24-hour ambulatory ECG monitoring was conducted in 26 patients with variant angina across a total recording period of 52 days.
Episodes of ST-segment elevation (≥1 mm) were tracked alongside symptom status (painful vs painless), diurnal timing, and concurrent arrhythmias.
Of 364 recorded ST-segment elevations, 79% were asymptomatic, with 72% occurring between 0:00 and 9:00 hours and peaking between 5:00 and 6:00 hours (13%).
Arrhythmias occurred in 12% of episodes and were more frequent during painful (32%) than painless (6%) episodes, though severe ventricular arrhythmias (ventricular tachycardia, couplets, bigeminy) occurred with similar frequency in painless (n = 8) and painful (n = 9) episodes.
Arrhythmias occurred more frequently during the ST-segment resolution/reperfusion phase (n = 38) than during ST-segment elevation onset (n = 8), with higher arrhythmia rates accompanying less frequent daily ischemic episodes.

Study Design

Type

Observational (n=26)

Structured PICO

Population

26 patients with variant angina evaluated by 24-hour ambulatory ECG monitoring over a total recording period of 52 days.

Exposure

24-hour ambulatory ECG monitoring

Outcome

Diurnal distribution of ST-segment elevation in relation to chest pain and the incidence of arrhythmias during the episodessurrogate

In patients with variant angina, asymptomatic coronary artery spasms predominantly occur early in the morning, and complex arrhythmias can appear during both symptomatic and asymptomatic episodes, particularly during the reperfusion phase.

Discussion

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Implication

May support extended ECG monitoring in variant angina; leaves open whether circadian-targeted interventions improve outcomes.

Cite This Study

Araki et al. (1983) conducted an observational in variant angina (n=26). ST-segment elevation episodes was evaluated on Diurnal distribution of ST-segment elevation and incidence of arrhythmias. In patients with variant angina, ST-segment elevations predominantly occurred early morning (72% between 0:00 and 9:00) and were mostly asymptomatic (79%), with arrhythmias common during reperfusion.

synapsesocial.com/papers/6a6dca4235aa2c282ce006e8 https://doi.org/10.1161/01.cir.67.5.995

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Diurnal distribution of ST-segment elevation and related arrhythmias in patients with variant angina: a study by ambulatory ECG monitoring.

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Diurnal distribution of ST-segment elevation and related arrhythmias in patients with variant angina: a study by ambulatory ECG monitoring.

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider