Continuous electrocardiographic monitoring during upper gastrointestinal endoscopy.

ECG changes were followed up in 69 patients under continuous electrocardiographic monitoring before, during and after esophago-gastro-duodenoscopy (EGD). Of these 32 (46.5%) had ischemic heart disease (IHD). One or more varied abnormalities including supraventricular or ventricular ectopic beats, sinus tachycardia or sinus bradycardia, intermittent right or left bundle branch block, S--T segment depression (and increased preexisting S--T segment depression), T wave flattening or inversion appeared during EGD. Only one patient with IHD developed anginal chest pain during endoscopy. Despite the high incidence of recorded rhythm abnormalities, these were transient, and no treatments were needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during EGD, particularly when it is performed in patients with IHD.