[Holter monitoring for short-term prognostication in patients with myocardium infarction].

Individualized prognosis is a topical problem in the management of acute myocardial infarction. Prediction of clinical course and outcome of the disease encounters many difficulties since it requires highly sensitive and specific measurements that must be safe and technically simple. Prognostic studies related to acute myocardial infarction are many, but combined effect of various factors remains poorly known. Thus far, clinical conditions of the patients were evaluated largely based on medical history data and assays of cardiospecific enzymes. The expected outcome of the disease was deduced from the results of complicated and expensive studies (e.g. coronaroventriculography) available in relatively few medical centres or VEM test usually performed since the 3d week after onset of the disease. Most publications do not mention the use of 24 hour ECG (Holter) monitoring for immediate prognosis although this method is readily available, safe, and can be applied at any stage of the disease. Its sensitivity and specificity for the diagnosis of coronary heart disease is 88 and 69% respectively. The method can be used to evaluate efficiency of therapy, detect arrhythmogenic complications and painless myocardial ischemia in patients with myocardial infarction.