[Qualifying patients with unstable angina for invasive tests based on electrocardiographic examinations]

In 40 patients with unstable angina pectoris a variety of electrocardiographic parameters were analysed. In all patients routine ECG, signal averaged high resolution ECG. 24 hour ECG recordings and heart rate variability analysis were performed at admission and repeated at 7 day of hospitalization. During second week patients underwent also exercise treadmill test. On basis of clinical presentation each patient was qualified to invasive investigation, 31 patients had need for urgent cardiac catherization (group I-urgent indications) and in the remaining 9 patients cardiac catherization was performed 3 months after the relief of acute symptoms (group II-non-urgent indications). The most impressive implications were draw from repeated 24 hour Holter ECG monitoring. In patients with urgent indications (gr. I) more frequent and severe ischemic episodes, as well as more frequent ventricular arrhythmias were observed. Patients from group I were unable to achieve higher grades on exercise treadmill test, while ST segment depression was comparable in both groups. Heart rate variability analysis showed greater disturbances of cardiac vagal control in group I. The number of critically stenosed vessels was similar in both groups, however left ventricular systolic dysfunction was observed mainly in patients with urgent indications for cardiac catherization.