SUMMARY NOTES IN THE RECORD s20651 (Duration: 24:35:00.000) Starting time, recording date: 14:20:00 19/01/2000 Lead 0: V4 Lead 1: MLIII Age: 84 Sex: M Comments: Patient is one day post anterior myocardial infarction thrombolysis. He shows a number of transient ST elevations in lead 0 which are associated with increases in heart rate. It is felt that these are due to increased dyskinesis of the anterior wall during increased heart rate. We cannot rule out the possibility that these changes represent heart rate induced increases in transmural ischemia, but prefer to call it "rate-related" and non-ischemic. There were minor reciprocal ST depressions in lead 1. Symptoms during Holter recording: No data Diagnoses: Anterior acute myocardial infarction Coronary artery disease Left ventricular failure Hypertension Treatment: Medications: Nitrates Aspirin Balloon Angioplasty: No data Coronary Artery bypass Grafting: No data History: Previous myocardial infarction Hypertension: Yes Left ventricular hypertrophy: No Cardiomyopathy: No Valve disease: No Electrolyte abnormalities: No Hypercapnia, anemia, hypotension, hyperventilation: No Atrioventricular nodal conduction delay: No Intraventricular conduction block: No Previous Myocardial Infarction: Yes, anterior Previous tests: ECG stress test: No Thallium/Stress echo: No Left ventricular function: Depressed Echocardiogram: No data Coronary Arteriography: No Baseline ECG: Subacute anterior myocardial infarction Holter Recording: Date: 19/01/2000 Recorder: Remco ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s20651.sta) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 19 Duration: 3:14:22 13.18% Axis shifts: 6 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 2 Duration: 28:54 1.96% Axis shifts: 17 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 21 Duration: 3:43:16 7.57% Axis shifts: 23 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 19 Duration: 3:17:22 13.38% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 19 Duration: 3:17:22 13.38% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s20651.stb) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 9 Duration: 2:13:46 9.07% Axis shifts: 6 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 17 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 9 Duration: 2:13:46 4.53% Axis shifts: 23 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 9 Duration: 2:13:46 9.07% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 9 Duration: 2:13:46 9.07% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s20651.stc) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 5 Duration: 1:33:28 6.34% Axis shifts: 6 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 17 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 5 Duration: 1:33:28 3.17% Axis shifts: 23 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 5 Duration: 1:33:28 6.34% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 5 Duration: 1:33:28 6.34% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s20651.atr) Total number of beats 103864 Normal beats 98127 Premature ventricular contractions 332 Atrial premature beats 5405