SUMMARY NOTES IN THE RECORD s30761 (Duration: 22:44:29.000) Starting time, recording date: 11:10:00 22/11/1999 Lead 0: E-S Lead 1: A-S Lead 2: A-I Age: 72 Sex: F Comments: Patient with coronary artery disease, and resting electrocardiogram is quite abnormal with ST down-sloping and biphasic T waves in leads 1 and 2. Ischemic episodes were present associated with increased heart rate. The changes were most convincing in lead 2 (with respect to ST morphology) but episodes were more frequent in lead 1. Symptoms during Holter recording: None reported Diagnoses: Coronary artery disease Angina Hypertension Previous myocardial infarction Hypercholesterolemia Treatment: Medications: Atenolol Imdur Cozar Lipitor Aspirin Lasix Synthroid (held during Holter) Balloon Angioplasty: No Coronary Artery bypass Grafting: Yes History: Angina Hypertension: Yes Left ventricular hypertrophy: No data Cardiomyopathy: No data Valve disease: No data Electrolyte abnormalities: No data Hypercapnia, anemia, hypotension, hyperventilation: No data Atrioventricular nodal conduction delay: No Intraventricular conduction block: No Previous Myocardial Infarction: Yes, 1998 Previous tests: ECG stress test: Yes Date: No data Findings: Positive, infero-lateral ischemia Thallium/Stress echo: Ejection fraction 50%, inferior hypokinesis Left ventricular function: Abnormal - ejection fraction 40% - 50% Echocardiogram: No data Coronary Arteriography: Lesion in right coronary artery Baseline ECG: Sinus bradycardia at 55 bpm, infero-lateral ST depression and down-sloping. Holter Recording: Date: 22/11/1999 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30761.sta) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Lead 1: Ischemic episodes: 25 Duration: 4:00:18 17.61% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Lead 2: Ischemic episodes: 7 Duration: 1:27:14 6.39% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Total: Ischemic episodes: 32 Duration: 5:27:32 8.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 12 Duration: 2:12:54 3.25% Combined: Ischemic episodes: 24 Duration: 4:11:06 18.40% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 4 Duration: 44:18 3.25% Combined [ischemic or rate-related]: ST segment episodes: 24 Duration: 4:11:06 18.40% Unreadable intervals: 4 Duration: 44:18 3.25% B. Criteria of 30 seconds and 100 microVolts (s30761.stb) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Lead 1: Ischemic episodes: 8 Duration: 2:04:28 9.12% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Lead 2: Ischemic episodes: 1 Duration: 54:14 3.97% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Total: Ischemic episodes: 9 Duration: 2:58:42 4.37% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 12 Duration: 2:12:54 3.25% Combined: Ischemic episodes: 7 Duration: 2:10:04 9.53% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 4 Duration: 44:18 3.25% Combined [ischemic or rate-related]: ST segment episodes: 7 Duration: 2:10:04 9.53% Unreadable intervals: 4 Duration: 44:18 3.25% C. Criteria of 60 seconds and 100 microVolts (s30761.stc) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Lead 1: Ischemic episodes: 6 Duration: 1:33:48 6.87% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Lead 2: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 4 Duration: 44:18 3.25% Total: Ischemic episodes: 6 Duration: 1:33:48 2.29% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 12 Duration: 2:12:54 3.25% Combined: Ischemic episodes: 6 Duration: 1:33:48 6.87% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 4 Duration: 44:18 3.25% Combined [ischemic or rate-related]: ST segment episodes: 6 Duration: 1:33:48 6.87% Unreadable intervals: 4 Duration: 44:18 3.25% QRS ATRUTH ANNOTATIONS (s30761.atr) Total number of beats 117044 Normal beats 113473 Premature ventricular contractions 3214 Fusions of ventricular and normal beat 58 Supraventricular premature or ectopic beats 299