A new semiautomated algorithm to quantify Holter-detected myocardial ischemia: preliminary experience in the Trimetazidine European Multicenter trial (TEMS).

Holter-detected myocardial ischemia, either painful or painless, is an important issue in the functional and prognostic evaluation of coronary patients. This paper describes one of the first attempts to reliably quantify the duration and severity of the ischemic ST-segment changes over a given period of time; the algorithm described here provides physicians with a global index of ischemia that is the total ischemic area, namely, the integral of ST-segment depression or elevation over time (expressed in mm x min). The diagnostic and prognostic power of this new index remains to be established and to be compared with the actually used simple measurements, i.e., the number and duration of ischemic events.