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(Circulation. 1974;50:962.)
© 1974 American Heart Association, Inc.

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Instant Electrocardiography

Use in Cardiac Exercise Programs

JOHN D. CANTWELL M.D.¹ GERALD F. FLETCHER M.D.¹

¹ From the Department of Medicine, Georgia Baptist Hospital, Atlanta, Georgia.

Instant electrocardiograms before and after physical activity were recorded three times per week for three to six months in ten patients with postmyocardial infarction angina pectoris who engaged in a physical training program. Four patients developed ST-segment depressions of over 2 mm following exercise and one of the four had associated ventricular ectopia. Three other patients had asymptomatic runs of ventricular tachycardia. Two of the latter subsequently developed ventricular fibrillation during moderate physical activity and one subsequently died suddenly at home while engaged in yardwork.

Instant electrocardiography represents a simple way to screen for patients prone to exercise-induced arrhythmias. It is felt that the latter should be on antiarrhythmic drugs and be limited to rather light physical activity such as certain flexibility exercises, noncompetitive team sports, and moderately brisk walking.

Key Words: Ventricular fibrillation • Ventricular tachycardia • Physical training program

Submitted on March 12, 1974
Accepted on July 19, 1974