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Volume 334:1545-1546 June 6, 1996 Number 23
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Myocardial Ischemia Detected by Ambulatory Monitoring after Myocardial Infarction

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 by Gill, J. B.
To the Editor: The article by Gill et al. (Jan. 11 issue),1 on the prognostic value of ambulatory electrocardiographic (ECG) monitoring early after myocardial infarction, concludes that the detection of ischemia during a 48-hour period was the best predictor of outcomes at 12 months.

The authors recommend the use of ambulatory ECG monitoring as the screening test of choice after myocardial infarction, over predischarge submaximal exercise testing or estimation of the left ventricular ejection fraction. Their study does not justify this recommendation for several reasons. First, a substantial proportion of patients (18 percent) did not undergo stress testing. Second, the . . . [Full Text of this Article]

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