INFORMATIVE VALUE OF PROGRAMMED VENTRICULAR PACING, 24-HOUR ECG MONITORING, AND BICYCLE ERGOMETRY IN THE DIAGNOSIS OF MYOCARDIAL ELECTRIC INSTABILITY IN VARIOUS CLINICAL TYPES OF ANGINA-PECTORIS

The informative value of programmed ventricular pacing (PVP), Holter monitoring (HM), and bicycle ergometry (BEM) in the diagnosis of myocardial electric instability was assessed in various clinical types of angina pectoris. An examination was made of 20 patients with first exercise-induced angina (FEIA), 33 with progressive exercise-induced angina (PEIA), 17 with spontaneous angina (SA), 30 with stable exercise-indiced angina (SEIA), and postinfarction angina. Myocardial electric instability was estimated from HM and BEM findings in patients with FEIA, SA, as well as in PEIA, SEIA in the presence of preserved myocardial contractility as evidenced by ventriculography. A clear-cut correlation was found between transient myocardial ischemia and the occurrence of high-grade ventricular arrhythmias for the patients from the above-mentioned groups. Lower myocardial contractility despite the nature of angina is an indication for PVP.