s20541 2 250 20685000 12:13:00 27/09/1999 s20541.dat 212 200/mV 12 0 12 -3571 0 V4 s20541.dat 212 200/mV 12 0 20 968 0 MLIII #Age: 23 Sex: F #Comments: # This unusual record demonstrates intermittent pre-excitation that # results in considerable variability of the ST segment. During # pre-excitation there is a depression in the ST segment. When alteration # in the conduction pattern is rapid, the average ST segment as displayed # by SEMIA shows minimal sustained change. When conduction shifts and # remains consistent for minutes, then the ST segment changes significantly. # To make matters more complicated, the degree of pre-excitation often # varies, producing intermediate QRS and ST morphological forms. This # record shows some rate-related episodes. #Symptoms during Holter recording: No data #Diagnoses: # Wolf-Parkinson-White (WPW) syndrome #Treatment: # Medications: No # Balloon Angioplasty: No data # Coronary Artery bypass Grafting: No data #History: # Palpitations # Hypertension: No # 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, but intermittent pre-excitation # Previous Myocardial Infarction: No # Previous tests: # ECG stress test: No # Thallium/Stress echo: No data # Left ventricular function: # Normal # Echocardiogram: No data # Coronary Arteriography: No # Baseline ECG: # WPW (short PR interval and delta wave) #Holter Recording: # Date: 27/09/1999 # Recorder: Remco