[An increased risk of kinesitherapy in silent myocardial ischemia?]

The effect of three-week standardized physical training on exercise-induced ischaemia was investigated in patients with silent ischaemia after myocardial infarction. 24-hour monitoring and exercise ECGs before and after the period of physical training, were undertaken in 32 men (mean age 53.6 +/- 8.1 years) with angiographically proven coronary heart disease. The protocol of the standardized exercise included bicycle ergometry, gymnastics, breathing and movement exercises, as well as nonstandardized walking or hiking. Following the training period the number of ischaemic episodes fell from 90 to 72 for the group as a whole and that of the asymptomatic episodes from 79 to 64. The number and severity of ventricular arrhythmias were similar during silent and symptomatic ischaemia. There was a significant increase in duration of exercise until reaching the ischaemia threshold (mean exercise duration 4.7 +/- 2.1 vs 5.9 +/- 2.5 min; P = 0.0007). There was no increased risk concerning ventricular arrhythmias.