The future

The first three decades of cardiac monitoring have focused on the rhythm of the heart. In the future ECG monitoring will include other aspects of the electrocardiogram. Ischemia and infarction are manifest on the surface electrocardiogram as ST-segment depression or elevation. Current systems are capable of monitoring ST-segment shifts. Such ECG monitors are useful in the setting of acute myocardial infarction and after percutaneous transluminal coronary angioplasty

(Gurfinkel.. etal 1994). Because ischemia can occur in different regions of the heart, the number of leads monitored has increased. The utility of ST-segment monitoring is not limited to cardiac patients. Ischemia is often detected in patients after non-cardiac surgery. The highest incidence of silent ischemia occurs during weaning from the ventilator. Thus monitoring the ST segment may allow for earlier intervention in patients with underlying coronary disease.

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