Continuous monitoring of ambulatory patients with coronary disease

Continuous monitoring of ambulatory patients has been of great value in the evaluation of paroxysmal rapid arrhythmias and of conduction disturbances as well as in the objective assessment of their therapy. This applies to both pharmacological and electrical treatment. However, it should be stressed that disorders of rhythm in general should be analyzed not only from the electrical point of view, but in the light of the clinical situation in which they occur. Although ST-T wave changes should not be used for diagnostic purposes the correlation of ischemic or injury patterns with the clinical findings has enhanced our knowledge of the natural history and therapy of ischemic heart disease. Technical requirements include proper electrode placement and stabilityas well as adequate selection of the monitoring lead system according to the needs. The tapes should be interpreted by a well trained individual with a thorough understanding of the potential sources of artefactual contours and of cardiac arrhythmias in general.