The accuracy of continuous 24 hour recordings (Holter's method) in the diagnosis of coronary insufficiency has been studied in 115 patients, by comparison with coronary arteriography. The technique was highly specific, but only fairly sensitive under the conditions of the study, because of the relative inactivity of the patients or the absence symptoms during the recording. It has allowed us to detect certain painfree or relatively painless forms of myocardial ischaemia which may be severe, and to have a clearer understanding of the effect of treatment. Comparison with the exercise electrocardiogram has shown inconsistencies due to the limitations of the two techniques. Holter's method is a particularly simple way of detecting coronary insufficiency, and is most useful when exercise tests are impossible or contraindicated.
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