SUMMARY NOTES ST ANNOTATIONS IN THE RECORD s30791 (Duration: 23:09:59.000) Starting time, recording date: 01/12/1999 Lead 0: E-S Lead 1: A-S Lead 2: A-I Age: 74 Sex: M Comments: The electrocardiogram at baseline is abnormal with ST concave depression. There also seems to be left axis deviation. The record shows numerous axis shifts. There are several episodes of ischemia related to increased heart rate, documented in all three leads. In the lead 0, however, the ST changes would be defined as rate-related if considered in isolation. They have been labeled as "ischemic" in light of the full 3-lead picture. Symptoms during Holter recording: None reported Diagnoses: Coronary artery disease Hypertension Angina Treatment: Medications: Atenolol Isosorbide (held during holter) Balloon Angioplasty: No Coronary Artery bypass Grafting: No History: Angina, hypertension Hypertension: Yes Left ventricular hypertrophy: Yes 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: No Previous tests: ECG stress test: Yes Date: December, 1998 Findings: Exercise induced ischemia. ST depression V4-V6 Thallium/Stress echo: Positive blood pool scan (MUGA) Left ventricular function: Good - ejection fraction 60% Echocardiogram: No data Coronary Arteriography: Lesions in right coronary artery (100%), left anterior descending coronary artery (90%), left circumflex coronary artery (sequential 70%, 95%). Baseline ECG: Normal sinus rhythm, left ventricular hypertrophy Holter Recording: Date: 01/12/1999 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30791.sta) Lead 0: Ischemic episodes: 6 Duration: 27:30 1.98% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 14 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 3 Duration: 20:06 1.45% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 12 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 4 Duration: 17:48 1.28% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 10 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 13 Duration: 1:05:24 1.57% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 36 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 5 Duration: 35:28 2.55% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 5 Duration: 35:28 2.55% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s30791.stb) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 14 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 10:26 0.75% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 12 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 2 Duration: 11:28 0.82% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 10 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 3 Duration: 21:54 0.53% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 36 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 2 Duration: 13:30 0.97% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 2 Duration: 13:30 0.97% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s30791.stc) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 14 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 10:26 0.75% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 12 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 1 Duration: 9:16 0.67% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 10 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 2 Duration: 19:42 0.47% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 36 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 1 Duration: 11:18 0.81% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 1 Duration: 11:18 0.81% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s30791.atr) Total number of beats 100482 Normal beats 100325 Premature ventricular contractions 57 Fusions of ventricular and normal beat 1 Supraventricular premature or ectopic beats 99