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September 9, 1974

Telemetry—Best Detective in Tracing CHD

JAMA. 1974;229(11):1475-1476. doi:10.1001/jama.1974.03230490063033

In 1964, Norland and Semler1 observed that the telemetry system of electrocardiographic recording, which they termed "dynamic electrocardiography," can be used for detecting angina pectoris or paroxysmal arrhythmias that cannot be demonstrated with conventional electrocardiography. The telemetry system used by these authors was developed by Holter.2 In 1968, Bellet et al3 used continuous electrocardiography during automobile driving to monitor normal subjects and patients with coronary heart disease (CHD). In contrast to findings in normal subjects, even during relatively favorable driving conditions, 16.7% of the patients in this study who had CHD manifested noticeable electrocardiographic changes, including ischemic ST segment depression, multifocal premature contractions, and ventricular bigeminal or trigeminal rhythm. More recently, Golding et al4 were able to detect by 24-hour electrocardiographic monitoring transient ST segment elevations during normal daily activity in persons in whom electrocardiograms both at rest and during stress-testing did not produce any abnormalities.