Prognostic significance of pre discharge one hour electrocardiographic monitoring in patients recovering from acute myocardial infarction.

ABSTRACT

During a 15 months period, 97 patients with AMI were monitored continuously at hospital discharge for one hour. The VPCs or no VPC noted during this period of continuous monitoring were correlated with subsequent cardiac events during one year follow up. Patients with complicated VPCs had a significantly higher incidence of cardiac deaths and non-fatal re-infarctions during one year follow up (54.5%) as compared to patients with no VPCs (6.5%) (p less than .001). Patients with higher grades of VPCs had more complicated course (30.3% to 66.7% for Lown Grade II to IV) as compared to 6.5% and 20.8% for grade Lown O and I. Though, the results of this 1 hour continuous monitoring at hospital discharge are not as sensitive as with ambulatory Holter monitoring as is evident from this study where complicated VPCs were detected in 11.4% patients vs. 33% with Holter monitoring, it could be a useful tool in institutions where the facility of Holter monitoring does not exist.