Afterward, Fish canceled his news conference, because "he's not feeling well," ATP spokesman Nicola Arzani said.
The 30-year-old Fish hadn't played a competitive match in 2½ months, taking time off because of an accelerated heartbeat.
Hours after losing a match at Key Biscayne, Fla., on March 29, Fish went to be checked by doctors after his heart started racing at night, and he pulled out of the U.S. Davis Cup team's quarterfinal against France the following week.
In May, doctors induced extreme palpitations to try to pinpoint the problem.
Fish reached the quarterfinals at Wimbledon last year, his best showing at the grass-court tournament.
Against Ramirez-Hidalgo -- at 34, the oldest man in the field -- Fish played his usual brand of attacking, serve-and-volley tennis. His serves topped 130 mph and he wound up with 61 winners, 43 more than Ramirez-Hidalgo.
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