[Comparison of 24-hour long-term electrocardiogram and exercise testing in the detection of ventricular arrhythmias...

The incidence of ventricular arrhythmias was investigated in 100 patients with a mean age of 53 years with symptom-limited maximal bicycle exercise testing and 24-hour long-term electrocardiogram. 47% of the patients developed ventricular ectopic beats under exercise and 78% in the long-term electrocardiogram. Repetitive forms such as couplets and ventricular tachycardias were found to be three times as frequent with monitoring than with exercise. Therefore it may be concluded that 24-hour monitoring was superior to exercise testing in the detection of incidence and severity of ventricular ectopies. In contrast, there was no significant difference between the two method when comparing exercise testing with the first hour of monitoring. Therefore it may be concluded that exercise testing exposes the grades of ectopic activity occurring during the first hour of the monitoring session. Two-thirds of patients without arrhythmias under exercise had no or insignificant ventricular arrhythmias under monitoring, whereas two-thirds of patients with exercise-induced arrhythmias had advanced grade ventricular ectopic activity with monitoring.