SUMMARY NOTES IN THE RECORD s20551 (Duration: 23:38:00.000)
Starting time, recording date: 14:24:00 19/01/1999
Lead 0: MLIII
Lead 1: V4
Age: 77 Sex: F
Comments:
This record, from a patient with known CAD, shows LBBB, and
includes 3 ischemic episodes and several axis shifts. There
were two conduction changes (increased degree of intra-ventricular
conduction block) that occurred in the midst of the final
ischemic episode.
Symptoms during Holter recording: No data
Diagnoses:
Coronary artery disease
Left bundle branch block
Hypertension
Treatment:
Medications:
Diltiazem
Nitrates
Heparin
Balloon Angioplasty: No data
Coronary Artery bypass Grafting: No data
History:
Unstable angina
Hypertension: Yes
Left ventricular hypertrophy: No
Cardiomyopathy: No
Valve disease: No
Electrolyte abnormalities: No
Hypercapnia, anemia, hypotension, hyperventilation: No
Atrioventricular nodal conduction delay: No
Intraventricular conduction block: Yes, LBBB
Previous Myocardial Infarction: No
Previous tests:
ECG stress test: No
Thallium/Stress echo: Positive
Left ventricular function:
Abnormal - Left ventricular ejection fraction 41%
Echocardiogram: No data
Coronary Arteriography:
Left anterior descending coronary artery 100% stenosis, right coronary artery 100% stenosis, left circumflex coronary artery 100% stenosis
Baseline ECG:
Left bundle branch block
Holter Recording:
Date: 19/01/1999
Recorder: Remco
ST ANNOTATIONS
A. Criteria of 30 seconds and 75 microVolts (s20551.sta)
Lead 0:
Ischemic episodes: 4 Duration: 1:44:12 7.35%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 1
Conduction-change shifts: 2
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 1 Duration: 1:09:24 4.89%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 4
Conduction-change shifts: 2
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 5 Duration: 2:53:36 6.12%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 5
Conduction-change shifts: 4
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 3 Duration: 1:45:04 7.41%
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: 1:45:04 7.41%
Unreadable intervals: 0 Duration: 0:00 0.00%
B. Criteria of 30 seconds and 100 microVolts (s20551.stb)
Lead 0:
Ischemic episodes: 3 Duration: 1:39:46 7.04%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 1
Conduction-change shifts: 2
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 1 Duration: 1:09:24 4.89%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 4
Conduction-change shifts: 2
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 4 Duration: 2:49:10 5.96%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 5
Conduction-change shifts: 4
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 2 Duration: 1:40:38 7.10%
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: 1:40:38 7.10%
Unreadable intervals: 0 Duration: 0:00 0.00%
C. Criteria of 60 seconds and 100 microVolts (s20551.stc)
Lead 0:
Ischemic episodes: 3 Duration: 1:39:46 7.04%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 1
Conduction-change shifts: 2
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 1 Duration: 1:09:24 4.89%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 4
Conduction-change shifts: 2
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 4 Duration: 2:49:10 5.96%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 5
Conduction-change shifts: 4
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 2 Duration: 1:40:38 7.10%
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: 1:40:38 7.10%
Unreadable intervals: 0 Duration: 0:00 0.00%
QRS ATRUTH ANNOTATIONS (s20551.atr)
Total number of beats 100629
Normal beats 94024
Premature ventricular contractions 111
Fusions of ventricular and normal beat 2
Supraventricular premature or ectopic beats 16
Bundle branch block beats (unspecified) 6476