SUMMARY NOTES IN THE RECORD s20274 (Duration: 22:56:08.000) Starting time, recording date: 13:15:00 11/09/1992 Lead 0: 0 Lead 1: 1 Age: 61 Sex: M Comments: Records s20271, s20272, s20273 and s20274 are from the same patient. This is the final record. The onset of ischemia often begins with peaking of T-waves, followed by ST depression. Rate increases often lead to ischemic changes sometimes only T-wave peaking, and sometimes also ST depression. Lead 0: It is easier to annotate since the ST deviation function has less variability. Lead 1: It is more difficult because of its higher variability compound to ischemic episodes. There are regions particularly seen in lead 1 after ischemia to the end of the record, where there are numerous ST shifts, generally associated with heart rate changes, which are felt to be manifestations of ischemia - some T-wave peaking, some ST depressions. Electrode locations were not recorded. Symptoms during Holter recording: No data Diagnoses: Coronary artery disease Treatment: Medications: Isordil Nitroglycerine Calcium channel blocker Aspirin Balloon Angioplasty: Yes Coronary Artery bypass Grafting: No History: Angina Hypertension: No Left ventricular hypertrophy: No Cardiomyopathy: No Valve disease: No Electrolyte abnormalities: No Hypercapnia, anemia, hypotension, hyperventilation: No Atrioventricular nodal conduction delay: No data Intraventricular conduction block: No data Previous Myocardial Infarction: No Previous tests: ECG stress test: No data Thallium/Stress echo: No data Left ventricular function: No data Echocardiogram: No data Coronary Arteriography: Lesions in left anterior descending coronary artery, left circumflex coronary artery Baseline ECG: No data Holter Recording: Date: 11/09/1992 Recorder: No data ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s20274.sta) Lead 0: Ischemic episodes: 55 Duration: 4:19:56 18.89% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 88 Duration: 8:03:34 35.14% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 15 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 143 Duration: 12:23:30 27.01% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 15 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 88 Duration: 8:10:06 35.61% 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: 88 Duration: 8:10:06 35.61% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s20274.stb) Lead 0: Ischemic episodes: 39 Duration: 3:41:24 16.09% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 63 Duration: 7:11:26 31.35% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 15 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 102 Duration: 10:52:50 23.72% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 15 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 63 Duration: 7:17:32 31.79% 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: 63 Duration: 7:17:32 31.79% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s20274.stc) Lead 0: Ischemic episodes: 33 Duration: 3:25:08 14.91% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 44 Duration: 6:26:26 28.08% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 15 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 77 Duration: 9:51:34 21.49% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 15 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 45 Duration: 6:34:32 28.67% 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: 45 Duration: 6:34:32 28.67% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s20274.atr) Total number of beats 121061 Normal beats 120351 Premature ventricular contractions 702 Fusions of ventricular and normal beat 2 Supraventricular premature or ectopic beats 6