SUMMARY NOTES IN THE RECORD s20341 (Duration: 22:29:13.000) Starting time, recording date: 13:08:00 12/11/1997 Lead 0: 0 Lead 1: 1 Age: 77 Sex: F Comments: Lead 0: Two major ischemic episodes and several other less dramatic ischemic episodes characterized by down-sloping ST segments, generally associated with increases in heart rate. Lead 1: This lead, however, showed no evidence of ischemic ST changes. Electrode locations were not recorded. Symptoms during Holter recording: None reported Diagnoses: Coronary artery disease Hypertension Syncope Spinal stenosis Treatment: Medications: Captopril Hydrochlorothiazide Balloon Angioplasty: No Coronary Artery bypass Grafting: No History: Syncope 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: No data Findings: Abnormal - infero-lateral ischemia, no angina Thallium/Stress echo: Positive antero-lateral ischemia Left ventricular function: Normal Echocardiogram: Borderline left ventricular hypertrophy Ejection fraction > 55% Coronary Arteriography: Done in 1998. Showed moderate 3-vessel disease, moderate left ventricular diastolic dysfunction, good ejection fraction Baseline ECG: Sinus bradycardia Left ventricular hypertrophy Left atrial abnormality Non-specific ST-T changes Holter Recording: Date: 12/11/1997 Recorder: No data ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s20341.sta) Lead 0: Ischemic episodes: 8 Duration: 1:55:50 8.59% 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: 0 Duration: 0:00 0.00% 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: 8 Duration: 1:55:50 4.29% 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% Combined: Ischemic episodes: 8 Duration: 1:55:50 8.59% 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: 8 Duration: 1:55:50 8.59% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s20341.stb) Lead 0: Ischemic episodes: 4 Duration: 1:26:52 6.44% 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: 0 Duration: 0:00 0.00% 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: 1:26:52 3.22% 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% Combined: Ischemic episodes: 4 Duration: 1:26:52 6.44% 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: 4 Duration: 1:26:52 6.44% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s20341.stc) Lead 0: Ischemic episodes: 3 Duration: 1:25:28 6.33% 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: 0 Duration: 0:00 0.00% 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: 3 Duration: 1:25:28 3.17% 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% Combined: Ischemic episodes: 3 Duration: 1:25:28 6.33% 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: 1:25:28 6.33% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s20341.atr) Total number of beats 100255 Normal beats 100092 Premature ventricular contractions 87 Fusions of ventricular and normal beat 2 Supraventricular premature or ectopic beats 74