Heart rate levels and ventricular ectopic activity during cardiac rehabilitation

The heart rate levels and the incidence and types of premature ventricular complexes (PVCs) during the rehabilitation of 40 patients with coronary artery disease, were compared with those during 24-hour ambulatory monitoring and during a symptom-limited exercise test. Thirty-six patients were studied 3 months or later after a myocardial infarction and four patients were studied after coronary bypass surgery. The last patient suffered from moderate angina pectoris. Peak heart rates during rehabilitation exceeded those during other activities in 34 out of 40 patients. Half of the patients reached even higher heart rate levels during the exercise test. Twenty-three patients had PVC during rehabilitation; frequent, multiform or repetitive PVC occurred in nine of these. During the exercise test, 24 patients had PVCs, while PVCs were observed on the ambulatory tape recording in 34 patients. Frequent, multiform, and repetitive PVCs occurred in eight patients during exercise testing and in 20 patients during monitoring. No relation was found between either the incidence or the type of PVC in individual patients under these three conditions. Thus, selection of patients with a high risk for arrhythmias during rehabilitation is not feasible by either exercise testing or ambulatory tape recording.