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Seventy-nine patients with angiographically documented coronary artery disease were studied with exercise ECG and Holter ECG for ischaemic ST segment changes. Fifty-four patients (68.3%) had ischaemia on exercise, 48 patients (62.0%) had ischaemic ST segment depression during Holter monitoring. Twenty-four (30%) of the patients with a positive exercise test and 30 (61%) with a positive Holter ECG were asymptomatic during the test, 83.7% of the total count of 456 episodes of spontaneous ischemia during Holter monitoring were silent. Forty-four patients (55.7%) had ischaemic ECG changes during exercise and Holter ECG, 20 patients (25.3%) were negative on both tests. Ten (12.7%) had only a positive exercise test and five (6.3%) only a positive Holter ECG. The sensitivity of Holter monitoring for the detection of ischaemia in patients with coronary artery disease is comparable to the sensitivity of the exercise ECG.
Günther et al. (Fri,) studied this question.