Rehabilitation of the Exercise Electrocardiogram
Authors: Paul Kligfield
Journal: Annals of Internal Medicine (1998)

Editorials15 June 1998Rehabilitation of the Exercise ElectrocardiogramPaul Kligfield, MDPaul Kligfield, MDThe New York Hospital-Cornell Medical Center; New York, NY 10021.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-12_Part_1-199806150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Evaluation of the electrocardiographic ST-segment response to exercise has been the most widely used laboratory method for the assessment of ischemic heart disease for half a century. The availability, accessibility, and relatively simple technological requirements of exercise electrocardiography make it a useful tool for the general internist as well as the subspecialist, but the limitations of standard test criteria are well recognized. Sensitivity for the detection of coronary disease is poor, particularly when only modest obstruction is present, and test responses are often indeterminate in the presence of upsloping ST-segment depression [1, 2]. As an inevitable consequence of low sensitivity ...References1. Goldschlager N, Selzer A, Cohn K. Treadmill stress tests as indicators of presence and severity of coronary artery disease. Ann Intern Med. 1976; 85:277-86. Google Scholar2. Chaitman BR. The changing role of the exercise electrocardiogram as a diagnostic and prognostic test for chronic ischemic heart disease. J Am Coll Cardiol. 1986; 8:1195-210. Google Scholar3. Rifkin RD, Hood WB Jr. Bayesian analysis of electrocardiographic exercise stress testing. N Engl J Med. 1977; 297:681-6. Google Scholar4. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979; 300:1350-8. Google Scholar5. Philbrick JT, Horowitz RI, Feinstein AR. 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Prognostic value of heart rate adjustment of exercise-induced ST segment depression in the Multiple Risk Factor Intervention Trial. J Am Coll Cardiol. 1996; 27:1437-43. Google Scholar15. Morise AP. Accuracy of heart rate-adjusted ST segments in populations with and without posttest referral bias. Am Heart J. 1997; 134:647-55. Google Scholar Author, Article, and Disclosure InformationAffiliations: The New York Hospital-Cornell Medical Center; New York, NY 10021.Corresponding Author: Paul Kligfield, MD, Division of Cardiology, Department of Medicine, The New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, NY 10021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byExercise Electrocardiogram TestingRethinking the Exercise ElectrocardiogramThe Diagnostic Value of Heart Rate During Exercise ElectrocardiographyHeart rate adjustment of ST depression in patients with coronary disease and negative standard exercise tests 15 June 1998Volume 128, Issue 12_Part_1Page: 1035-1037KeywordsAlgorithmsAngiographyElectrocardiographyExerciseExercise therapyIschemiaPopulation statisticsSpecificityStable coronary artery diseaseStandard exercise Issue Published: 15 June 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...