SUMMARY NOTES IN THE RECORD s30751 (Duration: 23:43:55.000) Starting time, recording date: 11:29:00 08/09/1999 Lead 0: E-S Lead 1: A-S Lead 2: A-I Age: 79 Sex: M Comments: This is the same patient as s30752. Patient with coronary artery disease and positive exercise tolerance test. Sinus rhythm with some ventricular ectopic activity. Rate-related ischemic ST depression was noted on a few occasions. The ischemia was evident in all three leads. Symptoms during Holter recording: Chest pressure, time not noted Diagnoses: Coronary artery disease Treatment: Medications: Atenolol Simvastatin Balloon Angioplasty: No Coronary Artery bypass Grafting: Triple bypass in 1994 History: Angina, coronary heart disease Hypertension: Yes 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: Left anterior fascicular block Previous Myocardial Infarction: No Previous tests: ECG stress test: Yes Date: July, 1996 Findings: Abnormal - 2 mm anterior ST segment depressions Thallium/Stress echo: Positive for inferior ischemia and wall motion abnormalities Left ventricular function: Hypokinesis and dyskinesis of infero-apical and septal walls, ejection fraction 44% Echocardiogram: Minimal left ventricular dysfunction & valvular regurgitation. Coronary Arteriography: Distal occlusion of posterior descending coronary artery Baseline ECG: Normal sinus rhythm, left anterior fascicular block, non-specific lateral ST-T abnormalities. Holter Recording: Date: 08/09/1999 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30751.sta) Lead 0: Ischemic episodes: 7 Duration: 36:06 2.54% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 1 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 2 Duration: 9:02 0.63% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 6 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 3 Duration: 10:52 0.76% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 2 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 12 Duration: 56:00 1.31% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 9 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 7 Duration: 36:40 2.58% 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: 7 Duration: 36:40 2.58% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s30751.stb) Lead 0: Ischemic episodes: 3 Duration: 14:48 1.04% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 1 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 2 Duration: 9:02 0.63% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 6 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 2 Duration: 8:40 0.61% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 2 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 7 Duration: 32:30 0.76% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 9 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 3 Duration: 15:22 1.08% 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: 3 Duration: 15:22 1.08% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s30751.stc) Lead 0: Ischemic episodes: 2 Duration: 13:18 0.93% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 1 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 7:24 0.52% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 6 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 1 Duration: 7:38 0.54% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 2 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 4 Duration: 28:20 0.66% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 9 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 2 Duration: 13:44 0.96% 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: 13:44 0.96% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s30751.atr) Total number of beats 106064 Normal beats 102514 Premature ventricular contractions 3476 Fusions of ventricular and normal beat 8 Supraventricular premature or ectopic beats 66