Identification of high-risk patients with silent myocardial ischemia after percutaneous transluminal coronary angioplasty by multilead monitoring.

Quantification of total ischemic burden can be improved by use of microprocessor-driven, multichannel, digital, ST-monitoring devices. ST deviation recorded during angioplasty provides a patient-specific template for identification of patients at increased risk for coronary events after angiographically successful dilation. In patients with ST-segment elevation, evidence of these ST "fingerprint" patterns are associated with elevated risk for coronary events in the postangioplasty period. Such risk is not seen in patients with ST-segment depression or with no ST changes. The increased monitoring capability afforded with digitized 3- or 12-lead monitoring creates new criteria for what constitutes accurate determination of total ischemic burden.