gms | German Medical Science

33rd International Congress on Electrocardiology

International Society of Electrocardiology

Prognostic Value Of The Asymptomatic Ecg – Changes At Holter Monitoring In Patients With Unstable Coronary Artery Disease

Meeting Abstract

  • L. Kardashevska - Donetsk State Medical University, Donetsk, Ukraine
  • corresponding author presenting/speaker V. Chupina - Donetsk State Medical University, Donetsk, Ukraine
  • N. Vatutin - Donetsk State Medical University, Donetsk, Ukraine
  • E. Kardashevska - Donetsk State Medical University, Donetsk, Ukraine

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice071

The electronic version of this article is the complete one and can be found online at:

Published: February 8, 2007

© 2007 Kardashevska et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The acute coronary syndrome (ACS) prognosis is often a complicated problem because the ischemia and arrhythmias could have no clinical manifestations up to a fatal outcome. The purpose of the study was the assessment of a prognostic value of the asymptomatic changes at Holter ECH monitoring in patients (pts) with ACS.

Material and methods: 48 pts, mean age 52,3±1,8 y.o, with ACS were were divided in 2 groups according to the ACS outcomes: I group (n=26) with the stabilization of the ACS to the angina of I-II functional class; II group (n=22) with an acute myocardial infarction (AMI) or death. In all cases the Holter ECG monitoring was performed. The ACS standard therapy included enoxaparine, nitrates, beta-blockers, ACE inhibitors, aspirin, statins.

Results: in the I group the ST depression was revealed in 20pts (77,0%), transient T wave inversion – in 5(19,2%) pts, ST elevation – in 6 (23,1%) pts, both ST elevation and depression – in 3(11,5 %) pts. In the pts of the II group ST depression was observed in 19(86,3%) pts, T wave inversion – in 14 (63,6%) pts, ST elevation – in 8(36,4%) pts, and both ST depression and elevation – in 6(27,3%) cases. 20% pts of the I group had asymptomatic ST depression including ¾ episodes during the day. In the II group 50% all ST alternants (66% on the day) were asymptomatic. Supraventricular extrasystoles were noticed in 100% cases in both groups, in the I group mostly on the day (78%), in the II – at the night (60%). Atrial fibrillation was observed in 2(7,7 %) pts in I group, and in 4(18,2 %) pts in II group. Ventricular extrasystoles (VE) were occurred in 92,3% cases in I group (67% on the day). In the II group the VE were detected in 50% cases, ventricular tachycardia - in 2 pts.

Conclusions: the pts with ACS and asymptomatic segment ST alternations, as well as T wave inversions observed at Holter ECG monitoring had a significantly more unfavorable prognosis.