THE INCIDENCE OF CARDIOVASCULAR COMPLICATIONS IDENTIFIED BY CONTINUOUS MONITORING IN A PHASE II CARDIAC REHABILITATION PROGRAM

Abstract

To determine the incidence of ECG abnormalities we reviewed the exercise training (ET) records of 94 participants (pts) successfully completing a monitored cardiac rehabilitation program (CRP) over a four year period. Pts were classified as follows: Group A (n=12)-significant unexpected ECG changes with exercise who received subsequent medical intervention (MEDI). Group B (n=9)-significant unexpected ECG changes with no MEDI and. those with no unexpected ECG changes but MEDI due to other cardiac symptoms. Group C (n=73)-no significant ECG charges during exercise and no MEDI during the program. Pts in group A were further classified as having other symptoms (As, n=4) or not having other symptoms (An, n=8). Seven of eight pts in group An had exercise induced ventricular arrhythmias (couplets or bigeminy) with no symptoms. Of the pts in group As three had chest pain during exercise associated with significant changes in their ECG; one had T wave rover sion, and two had ST depression greater than 2mm. One pt in both As and An showed sinus arrest. Pts in group B had complications which included chest pain and complex ventricular arrhythmias. In conclusion, continuous monitoring (CM) provided information not previously documented resulting in MEDI in 8.5% of the population (group An). This represented loccurrence for 423 hrs of monitored ET. CM supported symptoms in 4.3% of the population (group As) and increased the efficacy of CM to identify 1 occurrence per 282 hrs of ET. CM identified three pts from group B with significant ECG changes but no MEDI was instituted. Based on the ability of CM to identify otherwise undetected significant ECG changes with exercise we conclude that CM is of value in approximately 16% of the population evaluated