DETECTION OF MYOCARDIAL-ISCHEMIA WITH A COMPUTER-ASSISTED 12-LEAD 24-HOUR ECG MONITORING-SYSTEM (EAGLE) IN PATIENTS WITH SUSPECTED UNSTABLEANGINA

This study was undertaken to evaluate the diagnostic value of a new de vice, the 'EAGLE' computer-assisted multiple-lead long-term electrocar diography (ECG) monitoring and analyzing system, in patients with susp ected unstable angina and to compare the results with the Holler monit or. A total of 101 patients with a history of suspected unstable angin a underwent a simultaneous 24-h examination with the EAGLE and 2-chann el Holter monitors. The diagnosis of unstable angina was established i n 70 patients: 41 had significant organic stenosis. and 29 had coronar y spasm. Ischemic ST deviations were detected 229 times in 44 patients (62.9%) with the EAGLE system and 101 times in 20 patients (25.6%) wi th the Holter monitor. The sensitivity of myocardial ischemia in unsta ble angina with the EAGLE system was significantly higher than that wi th Holter monitor (62.9 vs 28.6%, p<0.05). The difference of sensitivi ty was due mainly to the low detection rate of the Holter monitor for asymptomatic myocardial ischemia (EAGLE vs Holter; 187 times vs 72 tim es) and myocardial ischemia in the infero-posterior area in patients w ith organic stenosis (30 times vs none). It is concluded that the EAGL E system is a sensitive tool for the diagnosis of unstable angina in p atients without significant ECG changes, and an excellent tool for eva luating silent myocardial ischemia or myocardial ischemia of the infer o-posterior area.