SUMMARY NOTES IN THE RECORD s30661 (Duration: 23:44:32.984)
Starting time, recording date: 12:15:00 11/02/1999
Lead 0: V4
Lead 1: V3
Lead 2: II
Age: 72 Sex: M
Comments:
This patient with extensive CAD shows a number of ST
depressions associated with paroxysms of atrial
tachycardia (PAT). Some ischemic changes were also
seen in associations with increased heart rate which
was not PAT. The patient has high-grade atrial ectopic
activity with many bursts of PAT. Ischemia is most
prominent in signal 0 (V4).
Symptoms during Holter recording: No data
Diagnoses:
2-vessel coronary artery disease
Unstable angina
Previous coronary artery bypass grafting
Left internal mammary artery graft to left anterior descending coronary artery
Chronic obstructive pulmonary disease
Hypertension
Benign prostatic hypertrophy
Treatment:
Medications:
Aspirin
Enalapril
Metoprolol
Prilosec
Cardura
Azmacort
Ventolin
Ipratropium
Balloon Angioplasty: No
Coronary Artery bypass Grafting: Four grafts in 1995
History:
Unstable angina and coronary artery bypass grafting in 1995
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: No
Previous Myocardial Infarction: No
Previous tests:
ECG stress test: Yes
Date: October, 1998
Findings: 2 mm ST depression, stopped due to dyspnea
Thallium/Stress echo: 1993 - no ischemia
Left ventricular function:
Normal - ejection fraction = 60%
Echocardiogram:
Normal left ventricular function
Coronary Arteriography:
1992: lesions in left anterior descending coronary artery, right coronary artery disease
Baseline ECG:
Normal sinus rhythm
Nonspecific ST changes
Atrial premature beats
Holter Recording:
Date: 11/02/1999
Recorder: Zymed
ST ANNOTATIONS
A. Criteria of 30 seconds and 75 microVolts (s30661.sta)
Lead 0:
Ischemic episodes: 21 Duration: 5:17:04 22.26%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 3
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 19 Duration: 4:53:26 20.60%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 4
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 2:
Ischemic episodes: 8 Duration: 4:19:24 18.21%
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%
Total:
Ischemic episodes: 48 Duration: 14:29:54 20.35%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 8
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 22 Duration: 5:19:42 22.44%
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: 22 Duration: 5:19:42 22.44%
Unreadable intervals: 0 Duration: 0:00 0.00%
B. Criteria of 30 seconds and 100 microVolts (s30661.stb)
Lead 0:
Ischemic episodes: 13 Duration: 5:03:22 21.30%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 3
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 12 Duration: 4:44:54 20.00%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 4
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 2:
Ischemic episodes: 6 Duration: 4:03:16 17.08%
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%
Total:
Ischemic episodes: 31 Duration: 13:51:32 19.46%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 8
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 13 Duration: 5:04:02 21.34%
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: 13 Duration: 5:04:02 21.34%
Unreadable intervals: 0 Duration: 0:00 0.00%
C. Criteria of 60 seconds and 100 microVolts (s30661.stc)
Lead 0:
Ischemic episodes: 11 Duration: 4:58:02 20.92%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 3
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 9 Duration: 4:41:08 19.73%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 4
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 2:
Ischemic episodes: 6 Duration: 4:03:16 17.08%
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%
Total:
Ischemic episodes: 26 Duration: 13:42:26 19.24%
Rate-related episodes: 0 Duration: 0:00 0.00%
Axis shifts: 8
Conduction-change shifts: 0
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 11 Duration: 4:58:42 20.97%
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: 11 Duration: 4:58:42 20.97%
Unreadable intervals: 0 Duration: 0:00 0.00%
QRS ATRUTH ANNOTATIONS (s30661.atr)
Total number of beats 144447
Normal beats 122769
Aberrated atrial premature beats 133
Premature ventricular contractions 60
Fusions of ventricular and normal beat 3
Supraventricular premature or ectopic beats 21482