SUMMARY NOTES IN THE RECORD s20041 (Duration: 23:54:26.000)
Starting time, recording date: 12:06:00 21/05/1997
Lead 0: 0
Lead 1: 1
Age: 60 Sex: M
Comments:
This is a difficult record. The baseline ST segment
is abnormal, it is scooped and slightly depressed.
There are a number of episodes of ST depression
associated with increased heart rate, some of which
are quite prolonged. These events were suggestive of
ischemia, and were so labeled.
Lead 0 shows many ischemic episodes and a few axis shifts.
Lead 1 shows many ischemic episodes, and the morphology of
the QRST complexes is quite similar to those of lead 0.
Electrode locations were not recorded.
Symptoms during Holter recording: None reported
Diagnoses:
Coronary artery disease
Previous coronary artery bypass grafting, 1986
Congestive heart failure
Chronic obstructive pulmonary disease
Previous transurethral resection of the prostate
Chronic renal failure (serum creatinine = 2.2)
Treatment:
Medications:
Nifedipine
Isordil
Metoprolol
Captopril
Lasix
KCl
Restoril
Aspirin
Balloon Angioplasty: No
Coronary Artery bypass Grafting: Yes, 1986
History:
Exertional angina, dyspnea on exertion
Hypertension: No
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: Incomplete right bundle branch block
Previous Myocardial Infarction: Yes, unknown date
Previous tests:
ECG stress test: No
Thallium/Stress echo: No
Left ventricular function: No data
Echocardiogram: No data
Coronary Arteriography:
June, 1997 - 99%left main coronary artery, 100%left anterior descending coronary artery, 100%left circumflex coronary artery. Internal mammary artery graft open but left anterior descending coronary artery occluded below anastamosis
Baseline ECG:
Normal sinus rhythm at 66 bpm
Left ventricular hypertrophy
Previous anterolateral myocardial infarction
Inferior ischemia
Possible old inferior myocardial infarction
Holter Recording:
Date: 21/05/1997
Recorder: ICR
ST ANNOTATIONS
A. Criteria of 30 seconds and 75 microVolts (s20041.sta)
Lead 0:
Ischemic episodes: 26 Duration: 6:01:18 25.19%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 5
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 30 Duration: 7:24:50 31.01%
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%
Total:
Ischemic episodes: 56 Duration: 13:26:08 28.10%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 11
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 28 Duration: 7:38:26 31.96%
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: 28 Duration: 7:38:26 31.96%
Unreadable intervals: 0 Duration: 0:00 0.00%
B. Criteria of 30 seconds and 100 microVolts (s20041.stb)
Lead 0:
Ischemic episodes: 17 Duration: 4:07:04 17.22%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 5
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 21 Duration: 5:21:32 22.42%
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%
Total:
Ischemic episodes: 38 Duration: 9:28:36 19.82%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 11
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 20 Duration: 5:37:56 23.56%
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: 20 Duration: 5:37:56 23.56%
Unreadable intervals: 0 Duration: 0:00 0.00%
C. Criteria of 60 seconds and 100 microVolts (s20041.stc)
Lead 0:
Ischemic episodes: 13 Duration: 3:26:18 14.38%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 5
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 16 Duration: 3:49:54 16.03%
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%
Total:
Ischemic episodes: 29 Duration: 7:16:12 15.20%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 11
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 18 Duration: 4:42:58 19.73%
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: 18 Duration: 4:42:58 19.73%
Unreadable intervals: 0 Duration: 0:00 0.00%
QRS ATRUTH ANNOTATIONS (s20041.atr)
Total number of beats 109304
Normal beats 102834
Premature ventricular contractions 6427
Fusions of ventricular and normal beat 7
Supraventricular premature or ectopic beats 36