MIT-BIH Arrhythmia Database Directory

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Records in the MIT-BIH Arrhythmia Database

This section contains notes and statistics that describe the contents of each record. The leads used for the upper and lower signals are given for each record immediately following the record number. Beat counts are given for the first five minutes of each record and the remainder of the record (the EC38-defined ``learning'' and ``test'' periods, respectively). Note that the totals include two types of non-beats (blocked APCs and ventricular flutter waves) for those few records in which they occur. The total duration of each record is 30 minutes and 5.556 seconds; durations noted below are rounded to the nearest second, and may not sum to exactly 30:06 because of accumulated rounding error. Heart rates are given in beats per minute measured over 3 R-R intervals.

Following the statistical summary and notes for each record are links to points of interest in each case. You may follow these links to view the signals and annotations using WAVE. To do so successfully, you must have configured your browser to use wavescript as a helper application, as described in WAVE and the Web (in the WAVE User's Guide).

Follow the links in this table to go directly to any record:
100 104 108 113 117 122 201 207 212 217 222 231
101 105 109 114 118 123 202 208 213 219 223 232
102 106 111 115 119 124 203 209 214 220 228 233
103 107 112 116 121 200 205 210 215 221 230 234


Record 100 (MLII, V5; male, age 69)

Medications: Aldomet, Inderal

BeatsBefore 5:00After 5:00Total
Normal36718722239
APC42933
PVC-11
Total37119022273

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm70-891 30:06

Signal qualityEpisodesDuration
Both clean1 30:06

Points of interest:

11:03 Normal sinus rhythm
25:13 PVC
26:09 APCs
27:55 Normal sinus rhythm

Record 101 (MLII, V1; female, age 75)

Medications: Diapres

BeatsBefore 5:00After 5:00Total
Normal34215181860
APC-33
Unclassifiable-22
Total34215231865

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm55-791 30:06

Signal qualityEpisodesDuration
Both clean3 30:01
Upper noisy1 0:04
Unreadable1 0:01

Points of interest:

1:34 Normal sinus rhythm
1:48 Noise
5:13 Noise/artifact
9:54 APC
24:32 APC

Record 102 (V5, V2; female, age 84)

Medications: Digoxin

BeatsBefore 5:00After 5:00Total
Normal98199
PVC134
Paced24317852028
Pacemaker fusion243256
Total36618212187

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm72-782 1:22
Paced rhythm68-783 28:44

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The rhythm is paced with a demand pacemaker. The PVCs are multiform.

Points of interest:

0:55 Paced rhythm
1:12 Transition from paced to normal sinus rhythm
1:28 PVC
2:30 Normal sinus rhythm
4:51 Pacemaker fusion beats
9:35 PVC
16:12 Paced rhythm

Record 103 (MLII, V2; male, age not recorded)

Medications: Diapres, Xyloprim

BeatsBefore 5:00After 5:00Total
Normal35517272082
APC-22
Total35517292084

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm62-921 30:06

Signal qualityEpisodesDuration
Both clean4 22:01
Upper noisy1 0:09
Lower noisy2 7:56

Points of interest:

1:09 Normal sinus rhythm
17:21 Normal sinus rhythm
19:15 APC, noise in lower signal
22:13 Noise in lower signal
23:33 Noise in lower signal
28:58 Noise in lower signal

Record 104 (V5, V2; female, age 66)

Medications: Digoxin, Pronestyl

BeatsBefore 5:00After 5:00Total
Normal6598163
PVC112
Paced19711831380
Pacemaker fusion104562666
Unclassifiable51318
Total37218572229

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm69-8222 3:52
Paced rhythm70-7823 26:13

Signal qualityEpisodesDuration
Both clean13 26:46
Upper noisy5 0:24
Lower noisy8 0:46
Both noisy12 2:09

Notes:
The rate of paced rhythm is close to that of the underlying sinus rhythm, resulting in many pacemaker fusion beats. The PVCs are multiform. Several bursts of muscle noise occur, but the signals are generally of good quality.

Points of interest:

3:42 PVC
5:13 Noise
5:52 Transition from paced to normal sinus rhythm
6:17 Noise
8:22 Noise in lower signal
26:51 Paced, normal, and pacemaker fusion beats
29:10 Paced, normal, and pacemaker fusion beats

Record 105 (MLII, V1; female, age 73)

Medications: Digoxin, Nitropaste, Pronestyl

BeatsBefore 5:00After 5:00Total
Normal40521212526
PVC122941
Unclassifiable-55
Total41721552572

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm78-1021 30:06

Signal qualityEpisodesDuration
Both clean31 22:18
Upper noisy3 0:10
Lower noisy28 3:27
Both noisy23 4:06
Unreadable4 0:04

Notes:
The PVCs are uniform. The predominant feature of this tape is high-grade noise and artifact.

Points of interest:

5:27 Artifact
7:57 PVC
15:16 Normal sinus rhythm
17:52 Artifacts
22:02 Noise
26:45 PVC
27:27 Noise
28:08 Noise
29:07 Noise

Record 106 (MLII, V1; female, age 24)

Medications: Inderal

BeatsBefore 5:00After 5:00Total
Normal27112361507
PVC60460520
Total33116962027

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm49-8721 22:36
Ventricular bigeminy55-10318 7:15
Ventricular trigeminy57-901 0:13
Ventricular tachycardia1211 0:02

Signal qualityEpisodesDuration
Both clean15 16:25
Lower noisy15 13:41

Notes:
The PVCs are multiform.

Points of interest:

0:19 Normal sinus rhythm, noise in lower signal
1:37 Ventricular couplets
2:53 Ventricular tachycardia, 3 beats
4:23 PVC
7:57 Noise in lower signal
10:52 Noise in lower signal
12:27 Ventricular bigeminy (two types)
16:17 Multiform PVCs, ventricular couplet
25:13 Ventricular couplet
25:52 Ventricular couplets

Record 107 (MLII, V1; male, age 63)

Medications: Digoxin

BeatsBefore 5:00After 5:00Total
PVC25759
Paced35117272078
Total35317842137

Ventricular ectopy

RhythmRateEpisodesDuration
Paced rhythm68-821 30:06

Signal qualityEpisodesDuration
Both clean2 30:04
Lower noisy1 0:02

Notes:
Complete heart block is present. The PVCs are multiform.

Points of interest:

0:44 Paced rhythm
12:30 PVC
19:54 PVC
20:38 Noise
25:52 PVC

Record 108 (MLII, V1; female, age 87)

Medications: Digoxin, Quinaglute

BeatsBefore 5:00After 5:00Total
Normal27914601740
APC-44
PVC41317
Fusion PVC-22
Junctional escape-11
Blocked APC2911
Total28514891774

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm44-781 30:06

Signal qualityEpisodesDuration
Both clean19 24:05
Upper noisy3 0:16
Lower noisy12 2:45
Both noisy8 3:01

Notes:
There is borderline first degree AV block and sinus arrhythmia. The PVCs are multiform. The lower channel exhibits considerable noise and baseline shifts.

Points of interest:

0:22 PVC, blocked APC, noise
4:51 Interpolated PVC
7:41 Axis shift
8:13 PVC, blocked APC, fusion PVC
10:55 Sinus arrhythmia
18:08 Fusion PVC-PVC couplet
20:05 Junctional escape beat
24:20 Blocked APC, APCs
28:10 Noise
29:00 Noise

Record 109 (MLII, V1; male, age 64)

Medications: Quinidine

BeatsBefore 5:00After 5:00Total
Left BBB42520672492
PVC63238
Fusion PVC2-2
Total43320992532

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm77-1011 30:06

Signal qualityEpisodesDuration
Both clean2 29:52
Lower noisy1 0:14

Notes:
There is first degree AV block. The PVCs are multiform.

Points of interest:

0:13 Fusion PVC
1:28 PVC
3:36 Normal sinus rhythm with left bundle branch block
4:46 PVC
5:27 Noise
14:01 PVC
17:13 PVC
19:21 PVC
26:09 Noise
28:03 PVC
28:28 Normal sinus rhythm with left bundle branch block
29:10 PVC

Record 111 (MLII, V1; female, age 47)

Medications: Digoxin, Lasix

BeatsBefore 5:00After 5:00Total
Left BBB34817752123
PVC-11
Total34817762124

RhythmRateEpisodesDuration
Normal sinus rhythm64-821 30:06

Signal qualityEpisodesDuration
Both clean5 29:47
Upper noisy1 0:07
Lower noisy3 0:11

Notes:
There is first degree AV block. There are short bursts of both baseline shifts and muscle noise, but in general, the quality is excellent.

Points of interest:

0:25 Normal sinus rhythm, first degree AVB
2:41 Baseline shift noise
3:52 Noise
4:04 Axis shift (in upper signal)
8:31 PVC
11:53 Axis shift
15:41 Noise
19:54 Noise
27:02 Noise

Record 112 (MLII, V1; male, age 54)

Medications: Digoxin, Pronestyl

BeatsBefore 5:00After 5:00Total
Normal42821092537
APC-22
Total42821112539

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm74-911 30:06

Signal qualityEpisodesDuration
Both clean6 29:11
Upper noisy2 0:21
Lower noisy3 0:33

Notes:
There is S-T segment depression in the upper channel.

Points of interest:

11:40 APC
12:30 Axis shift
12:49 APC, noise

Record 113 (MLII, V1; female, age 24)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal28815011789
Aberrated APC156
Total28915061795

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm48-871 30:06

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The variation in the rate of normal sinus rhythm is possibly due to a wandering atrial pacemaker.

Points of interest:

4:20 Moderate baseline wander
8:22 Aberrated APC
11:48 Sinus arrhythmia with variation in P-wave morphology
12:27 Sinus arrhythmia
22:10 Aberrated APC
29:01 Sinus arrhythmia

Record 114 (V5, MLII; female, age 72)

Medications: Digoxin

BeatsBefore 5:00After 5:00Total
Normal26115591820
APC-1010
Junctional premature112
PVC133043
Fusion PVC-44
Total27516041879

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm51-822 30:01
SVTA102-1221 0:05

Signal qualityEpisodesDuration
Both clean4 29:18
Upper noisy4 0:47

Notes:
The PVCs are uniform.

Points of interest:

0:00 Normal sinus rhythm
1:20 PVC
3:39 PVC
3:56 Late-cycle PVC
4:35 Late-cycle PVC
5:36 Ventricular couplet
8:31 PVCs
9:26 PVC, muscle noise
11:37 SVTA, PVC, junctional premature beat
20:02 Noise
29:29 Baseline artifact

Record 115 (MLII, V1; female, age 39)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal31616371953
Total31616371953

RhythmRateEpisodesDuration
Normal sinus rhythm50-841 30:06

Signal qualityEpisodesDuration
Both clean2 29:56
Lower noisy1 0:09

Points of interest:

0:55 Normal sinus rhythm
3:22 Sinus arrhythmia
15:52 Baseline wander in lower signal
21:28 Noise in lower signal
27:05 Artifacts in lower signal
28:42 Normal sinus rhythm

Record 116 (MLII, V1; male, age 68)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal38419182302
APC-11
PVC1198109
Total39520172412

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm74-861 30:06

Signal qualityEpisodesDuration
Both clean5 29:41
Upper noisy4 0:25

Notes:
There are two PVC forms.

Points of interest:

0:44 Normal sinus rhythm
1:31 PVCs
10:00 Ventricular couplet
12:32 PVC
16:37 Noise, saturation in upper signal
23:08 Noise, saturation in upper signal
25:47 Ventricular couplet

Record 117 (MLII, V2; male, age 69)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal25112831534
APC-11
Total25112841535

RhythmRateEpisodesDuration
Normal sinus rhythm48-661 30:06

Signal qualityEpisodesDuration
Both clean2 29:55
Upper noisy1 0:01
Both noisy1 0:09

Points of interest:

3:56 Normal sinus rhythm
11:58 Noise, APC
22:27 Normal sinus rhythm

Record 118 (MLII, V1; male, age 69)

Medications: Digoxin, Norpace

BeatsBefore 5:00After 5:00Total
Right BBB34918172166
APC108696
PVC31316
Blocked APC3710
Total36519232288

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm54-911 30:06

Signal qualityEpisodesDuration
Both clean7 29:32
Upper noisy2 0:07
Lower noisy2 0:10
Both noisy2 0:18

Notes:
The PVCs are multiform.

Points of interest:

3:39 PVC
8:31 Noise
9:23 PVC
13:47 Blocked APC
22:32 APC, blocked APC, PVC
23:25 APCs
25:41 PVC, APC
26:23 PVCs
26:48 Noise
28:58 Atrial couplet
29:53 APCs

Record 119 (MLII, V1; female, age 51)

Medications: Pronestyl

BeatsBefore 5:00After 5:00Total
Normal24612971543
PVC80364444
Total32616611987

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm61-8449 22:36
Ventricular bigeminy52-9137 3:55
Ventricular trigeminy56-7717 3:34

Signal qualityEpisodesDuration
Both clean3 29:35
Lower noisy2 0:30

Notes:
The PVCs are uniform.

Points of interest:

1:55 PVC
2:38 Ventricular trigeminy
4:51 Ventricular bigeminy
8:42 Normal sinus rhythm
20:05 Noise
25:33 Noise

Record 121 (MLII, V1; female, age 83)

Medications: Digoxin, Isordil, Nitropaste

BeatsBefore 5:00After 5:00Total
Normal30315581861
APC-11
PVC-11
Total30315601863

RhythmRateEpisodesDuration
Normal sinus rhythm55-831 30:06

Signal qualityEpisodesDuration
Both clean6 29:09
Upper noisy3 0:16
Lower noisy3 0:39
Both noisy1 0:01

Points of interest:

1:06 Normal sinus rhythm
3:33 Noise in lower signal
16:48 APC, PVC
24:32 Noise
26:01 Noise

Record 122 (MLII, V1; male, age 51)

Medications: Digoxin, Lasix, Pronestyl

BeatsBefore 5:00After 5:00Total
Normal42220542476
Total42220542476

RhythmRateEpisodesDuration
Normal sinus rhythm67-971 30:06

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The lower channel has low-amplitude high-frequency noise throughout.

Points of interest:

1:09 Noise in lower signal
13:47 Normal sinus rhythm
28:25 Normal sinus rhythm

Record 123 (MLII, V5; female, age 63)

Medications: Digoxin, Inderal

BeatsBefore 5:00After 5:00Total
Normal24912661515
PVC-33
Total24912691518

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm41-651 30:06

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The PVCs are uniform and interpolated.

Points of interest:

22:10 Sinus arrhythmia
25:11 Interpolated PVC
27:41 Interpolated PVC
28:36 Sinus arrhythmia

Record 124 (MLII, V4; male, age 77)

Medications: Digoxin, Isordil, Quinidine

BeatsBefore 5:00After 5:00Total
Right BBB23812931531
APC-22
Junctional premature141529
PVC-4747
Fusion PVC-55
Junctional escape-55
Total25213671619

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm47-646 28:36
Nodal (junctional) rhythm56-642 0:30
Ventricular trigeminy51-592 0:22
Idioventricular rhythm53-613 0:37

Signal qualityEpisodesDuration
Both clean2 29:53
Lower noisy1 0:13

Notes:
The PVCs are multiform. The junctional escape beats follow PVCs.

Points of interest:

4:43 Accelerated junctional rhythm
5:09 Accelerated idioventricular rhythm, 20 beats
5:21 Accelerated idioventricular rhythm (continued from previous strip)
9:05 Noise in lower signal
10:27 Accelerated idioventricular rhythm
17:38 Accelerated idioventricular rhythm
20:13 APC
23:22 Ventricular trigeminy
26:03 PVC
27:41 PVC, junctional escape beats

Record 200 (MLII, V1; male, age 64)

Medications: Digoxin, Quinidine

BeatsBefore 5:00After 5:00Total
Normal30514381743
APC22830
PVC126700826
Fusion PVC-22
Total43321682601

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm69-11170 15:58
Ventricular bigeminy60-10871 13:52
Ventricular tachycardia90-1417 0:15

Signal qualityEpisodesDuration
Both clean14 21:44
Upper noisy6 0:44
Lower noisy16 6:36
Both noisy8 1:02

Notes:
The PVCs are multiform. There are occasional bursts of high-frequency noise in the upper channel, and severe noise and artifact in the lower channel.

Points of interest:

1:42 Ventricular tachycardia, 3 beats
5:38 Noise
18:14 Ventricular tachycardia, 4 beats
20:52 Noise
24:49 Ventricular tachycardia, 3 beats
26:12 Ventricular couplets
28:31 Ventricular couplet
29:01 APC, ventricular bigeminy
29:18 APC, PVC
29:51 PVCs

Record 201 (MLII, V1; male, age 68)

Medications: Digoxin, Hydrochlorthiazide, Inderal, KCl

BeatsBefore 5:00After 5:00Total
Normal44011851625
APC-3030
Aberrated APC29597
Junctional premature-11
PVC-198198
Fusion PVC-22
Junctional escape-1010
Blocked APC-3737
Total44215582000

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm31-6116 12:57
SVTA1241 0:02
Atrial fibrillation56-1493 10:06
Nodal (junctional) rhythm37-603 0:24
Ventricular trigeminy49-5612 6:37

Signal qualityEpisodesDuration
Both clean2 30:00
Upper noisy1 0:02
Lower noisy1 0:01
Both noisy1 0:02

Notes:
The PVCs are uniform and late-cycle. Junctional escape beats occur following episodes of ventricular trigeminy.

Points of interest:

0:00 Atrial fibrillation
6:15 Transition from atrial fibrillation to nodal rhythm
7:52 Onset of atrial fibrillation with aberrated beats
8:53 Blocked APCs
18:14 Noise
20:16 PVCs, atrial couplet
22:33 Ventricular trigeminy
23:50 Normal sinus rhythm
24:15 Aberrated atrial couplet, fusion PVC
25:19 Aberrated atrial couplets with right and left bundle branch block
26:20 Supraventricular tachyarrhythmia with aberration, 3 beats
28:03 Atrial fibrillation with aberration

Record 202 (MLII, V1; male, age 68)

Medications: Digoxin, Hydrochlorthiazide, Inderal, KCl

BeatsBefore 5:00After 5:00Total
Normal26118002061
APC-3636
Aberrated APC-1919
PVC41519
Fusion PVC-11
Total26518712136

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm49-693 19:31
Atrial flutter101-1431 0:48
Atrial fibrillation60-1484 9:46

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The PVCs are uniform and late-cycle. This record was taken from the same analog tape as record 201.

Points of interest:

10:16 Normal sinus rhythm, PVCs
12:24 APCs, PVC
12:41 Aberrated APCs, PVC
18:22 Normal sinus rhythm, bradycardia
18:45 Aberrated APCs
18:59 Onset of atrial fibrillation with aberrated beats
21:10 Atrial fibrillation, PVC
21:26 End of atrial fibrillation
22:13 Atrial fibrillation, aberrated beats
25:58 Atrial flutter with 2:1 conduction
27:55 Atrial fibrillation, aberrated beat
29:35 Atrial fibrillation

Record 203 (MLII, V1; male, age 43)

Medications: Coumadin, Digoxin, Heparin, Hygroton, Lasix

BeatsBefore 5:00After 5:00Total
Normal42621032529
Aberrated APC2-2
PVC71373444
Fusion PVC-11
Unclassifiable-44
Total49924812980

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm63-1731 2:43
Atrial flutter61-1802 5:14
Atrial fibrillation54-18020 21:32
Ventricular trigeminy100-1161 0:04
Ventricular tachycardia124-18921 0:33

Signal qualityEpisodesDuration
Both clean21 24:28
Upper noisy20 3:17
Lower noisy7 1:49
Both noisy8 0:30
Unreadable1 0:02

Notes:
The PVCs are multiform. There are QRS morphology changes in the upper channel due to axis shifts. There is considerable noise in both channels, including muscle artifact and baseline shifts. This is a very difficult record, even for humans!

Points of interest:

5:00 Ventricular tachycardia, 4 beats and 9 beats
13:14 Atrial fibrillation, ventricular couplets
15:02 Noise
22:02 Ventricular couplet, PVCs
23:25 Noise
24:04 PVCs
24:46 Noise
26:39 Ventricular tachycardia, 7 beats
26:51 Ventricular couplet, PVCs
27:15 Ventricular tachycardia, 3 beats

Record 205 (MLII, V1; male, age 59)

Medications: Digoxin, Quinaglute

BeatsBefore 5:00After 5:00Total
Normal44821232571
APC123
PVC66571
Fusion PVC-1111
Total45522012656

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm80-997 29:43
Ventricular tachycardia79-2166 0:23

Signal qualityEpisodesDuration
Both clean2 29:43
Lower noisy1 0:23

Notes:
The PVCs are of two forms, one of which is much more common than the other.

Points of interest:

4:57 Ventricular tachycardia, 8 beats and 10 beats
14:54 Noise in lower signal
15:22 Ventricular tachycardia, 3 beats
16:03 PVC
16:15 Fusion PVCs
19:57 PVC, APC
24:18 Ventricular tachycardia, 12 beats, start of VR, 13 beats
24:30 End of VR, 3-beat VT (continued from previous strip)
27:57 PVCs

Record 207 (MLII, V1; female, age 89)

Medications: Digoxin, Quinaglute

BeatsBefore 5:00After 5:00Total
Left BBB8113761457
Right BBB86-86
APC-107107
PVC1014105
Ventricular flutter wave132340472
Ventricular escape-105105
Total40019322332

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm57-9010 22:20
SVTA108-1301 0:52
Ventricular bigeminy49-834 2:38
Idioventricular rhythm29-711 1:49
Ventricular tachycardia118-1192 0:03
Ventricular flutter143-3586 2:24

Signal qualityEpisodesDuration
Both clean8 28:59
Upper noisy4 0:22
Lower noisy3 0:25
Both noisy1 0:19

Notes:
This is an extremely difficult record. The predominant rhythm is normal sinus with first degree AV block and left bundle branch block. There are periods when the conduction block changes to a right bundle branch block pattern. The PVCs are multiform. Idioventricular rhythm appears following the longest episode of ventricular flutter. The record ends during the episode of SVTA.

Points of interest:

0:00 Ventricular bigeminy with right bundle branch block
0:33 Ventricular couplet, ventricular tachycardia, ventricular flutter
0:45 Ventricular flutter (continued from previous strip)
0:57 Ventricular flutter, VT (continued from previous strip)
1:28 Normal sinus rhythm with first degree AV block
2:07 Ventricular couplet, left and right bundle branch block
2:41 Ventricular bigeminy with right bundle branch block
4:25 Ventricular couplet, ventricular flutter
5:19 Noise
6:56 Noise
17:35 Normal sinus rhythm with first degree AV block
25:36 Ventricular bigeminy with LBBB, ventricular flutter
26:10 Ventricular flutter
27:14 End of ventricular flutter
29:10 Atrial couplet, SVTA (104 beats, to end of record)

Record 208 (MLII, V1; female, age 23)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal27813081586
SVPC-22
PVC168824992
Fusion PVC72301373
Unclassifiable-22
Total51824372955

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm91-13427 24:43
Ventricular trigeminy79-12926 5:22

Signal qualityEpisodesDuration
Both clean8 24:46
Lower noisy8 4:14
Both noisy8 1:02
Unreadable1 0:03

Notes:
The PVCs are uniform. The couplets, many of which include a fusion PVC, are often seen in a bigeminal pattern. The triplets each consist of two PVCs and a fusion PVC.

Points of interest:

14:57 Noise/artifact
17:02 Ventricular couplets
19:10 Ventricular trigeminy
21:06 Noise
23:00 Noise
28:08 Ventricular triplet
28:58 Ventricular couplets, isolated PVCs
29:37 Ventricular triplet

Record 209 (MLII, V1; male, age 62)

Medications: Aldomet, Hydrodiuril, Inderal

BeatsBefore 5:00After 5:00Total
Normal47521462621
APC11372383
PVC-11
Total48625193005

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm82-11611 28:23
SVTA106-17110 1:42

Signal qualityEpisodesDuration
Both clean10 23:21
Lower noisy10 6:44

Points of interest:

0:47 APC
5:50 Noise
12:57 PVC
14:21 SVTA, 14 beats
23:25 APCs
28:17 Noise, APC
28:33 SVTA, 4 beats, 13 beats
29:10 SVTA, 6 beats

Record 210 (MLII, V1; male, age 89)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal41320102423
Aberrated APC22022
PVC30164194
Fusion PVC1910
Ventricular escape-11
Total44622042650

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Atrial fibrillation63-1589 29:30
Ventricular bigeminy69-1095 0:23
Ventricular trigeminy85-1141 0:07
Ventricular tachycardia103-1612 0:06

Signal qualityEpisodesDuration
Both clean6 29:16
Upper noisy3 0:05
Lower noisy3 0:14
Both noisy5 0:30
Unreadable1 0:01

Notes:
The PVCs are multiform.

Points of interest:

3:47 Noise
6:56 Ventricular tachycardia, 6 beats
13:14 Ventricular couplets
15:55 Noise
17:32 Aberrated beat
17:57 Ventricular tachycardia, 6 beats
20:33 PVCs
29:15 PVCs, aberrated beat, ventricular escape beat, fusion PVC

Record 212 (MLII, V1; female, age 32)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal129794923
Right BBB33414911825
Total46322852748

RhythmRateEpisodesDuration
Normal sinus rhythm63-1081 30:06

Signal qualityEpisodesDuration
Both clean7 29:41
Lower noisy3 0:10
Both noisy4 0:15

Notes:
There is rate-related right bundle branch block which appears when the heart rate exceeds approximately 90 bpm.

Points of interest:

0:05 Normal sinus rhythm with right bundle branch block
18:42 Noise
24:21 End of RBBB in normal sinus rhythm as heart rate decreases
24:38 Sinus arrhythmia
26:45 Noise
28:46 Start of RBBB in normal sinus rhythm as heart rate increases

Record 213 (MLII, V1; male, age 61)

Medications: Digoxin

BeatsBefore 5:00After 5:00Total
Normal43222092641
APC12425
Aberrated APC-33
PVC25195220
Fusion PVC93269362
Total55127003251

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm101-11322 29:01
Ventricular bigeminy102-11619 1:00
Ventricular tachycardia110-1172 0:04

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The PVCs are multiform and usually late-cycle, frequently resulting in fusion PVCs. The morphology of the fusion PVCs varies from almost normal to almost identical to that of the PVCs.

Points of interest:

3:39 Fusion PVC couplet
14:48 Ventricular tachycardia, 3 beats
15:05 Fusion PVC/PVC couplet
15:38 APC
17:30 Ventricular tachycardia, 4 beats
17:55 PVCs, fusion PVCs, APC
24:43 Fusion PVC, PVCs, aberrated APC
25:58 Aberrated atrial couplet
26:51 Ventricular bigeminy
28:56 Fusion PVCs, PVC

Record 214 (MLII, V1; male, age 53)

Medications: Digoxin, Dilantin

BeatsBefore 5:00After 5:00Total
Left BBB33916642003
PVC44212256
Fusion PVC-11
Unclassifiable-22
Total38318792262

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm49-9213 28:53
Ventricular trigeminy71-8710 1:08
Ventricular tachycardia126-1502 0:05

Signal qualityEpisodesDuration
Both clean2 29:59
Upper noisy2 0:02
Both noisy1 0:04

Notes:
The PVCs are multiform. There are two episodes of artifactual amplitude decrease and one occurrence of tape slippage.

Points of interest:

0:30 Normal sinus rhythm with left bundle branch block, PVC
2:21 Multiform PVCs
2:35 Ventricular couplet
3:25 Artifactual amplitude changes
3:56 Ventricular couplet
5:08 Tape slippage
5:38 Ventricular tachycardia, 3 beats
13:53 Ventricular tachycardia, 3 beats
23:17 Ventricular couplet
27:52 PVC/fusion PVC couplet

Record 215 (MLII, V1; male, age 81)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal53426613195
APC123
PVC33131164
Fusion PVC-11
Total56827953363

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm81-1243 30:03
Ventricular tachycardia174-1772 0:02

Signal qualityEpisodesDuration
Both clean14 29:18
Upper noisy1 0:00
Lower noisy14 0:39
Both noisy2 0:09

Notes:
The PVCs are multiform. There are two very short occurrences of tape slippage (each less than one second in duration).

Points of interest:

2:55 Ventricular tachycardia, 3 beats
3:11 Noise, ventricular couplet
9:46 PVC, APC
15:58 PVC
20:25 Ventricular tachycardia, 3 beats
22:16 Tape slippage
24:57 Ventricular couplet
27:30 Ventricular triplet
27:57 Noise in lower signal
29:42 Tape slippage, ventricular couplet

Record 217 (MLII, V1; male, age 65)

Medications: Digoxin, Lasix, Quinidine

BeatsBefore 5:00After 5:00Total
Normal9235244
PVC22140162
Paced30112411542
Pacemaker fusion31229260
Total36318452208

Ventricular ectopy

RhythmRateEpisodesDuration
Atrial fibrillation69-10324 4:12
Paced rhythm65-7633 25:10
Ventricular bigeminy68-919 0:42
Ventricular tachycardia1031 0:02

Signal qualityEpisodesDuration
Both clean3 30:00
Upper noisy2 0:05

Notes:
The PVCs are multiform.

Points of interest:

0:00 Paced rhythm, pacemaker fusion beat
0:33 PVC
1:23 PVCs, pacemaker fusion beats
4:18 Paced beats, pacemaker fusion beats, normal beats, PVCs
6:12 Ventricular couplet
6:51 Ventricular couplet
7:05 Ventricular tachycardia, 3 beats
12:27 Ventricular bigeminy with paced beats
14:01 Noise
15:30 Atrial fibrillation
16:56 Ventricular couplet
22:27 Atrial fibrillation

Record 219 (MLII, V1; male, age not recorded)

Medications: Digoxin

BeatsBefore 5:00After 5:00Total
Normal36717152082
APC-77
PVC135164
Fusion PVC1-1
Blocked APC-133133
Total38119062287

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm38-758 6:01
Atrial fibrillation51-10310 23:47
Ventricular bigeminy71-882 0:08
Ventricular trigeminy74-941 0:10

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
Following some conversions from atrial fibrillation to normal sinus rhythm are pauses up to 3 seconds in duration. The PVCs are multiform.

Points of interest:

2:49 Fusion PVC
5:08 APC
5:22 Onset of atrial fibrillation
13:50 End of atrial fibrillation, conversion pause, APC, blocked APC
19:00 End of atrial fibrillation
19:57 Normal sinus rhythm, blocked APCs
22:11 End of atrial fibrillation, conversion pause, blocked APCs
22:43 Blocked APCs
24:43 PVC
26:09 Atrial fibrillation
28:55 Atrial fibrillation, PVCs

Record 220 (MLII, V1; female, age 87)

Medications: Digoxin

BeatsBefore 5:00After 5:00Total
Normal35316011954
APC19394
Total35416942048

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm58-749 29:50
SVTA113-1508 0:16

Signal qualityEpisodesDuration
Both clean3 29:58
Lower noisy2 0:08

Points of interest:

6:46 SVTA (3 runs)
10:41 SVTA (2 runs)
18:10 Atrial couplets
20:29 SVTA, atrial couplets
23:58 Noise in lower signal
25:44 Atrial couplet
29:40 APC

Record 221 (MLII, V1; male, age 83)

Medications: Hydrochlorthiazide, Lasix

BeatsBefore 5:00After 5:00Total
Normal32717042031
PVC80316396
Total40720202427

Ventricular ectopy

RhythmRateEpisodesDuration
Atrial fibrillation47-11012 29:17
Ventricular bigeminy88-1011 0:03
Ventricular trigeminy69-928 0:42
Ventricular tachycardia122-1302 0:04

Signal qualityEpisodesDuration
Both clean7 29:48
Upper noisy1 0:04
Lower noisy5 0:14

Notes:
The PVCs are multiform, but one form is much more common than the others.

Points of interest:

0:00 Atrial fibrillation, PVCs
2:43 Ventricular couplet
13:00 Ventricular tachycardia, 3 beats
13:56 Ventricular tachycardia, 3 beats
17:49 Ventricular couplet
19:12 PVCs
19:42 Noise
20:44 Ventricular couplet

Record 222 (MLII, V1; female, age 84)

Medications: Digoxin, Quinidine

BeatsBefore 5:00After 5:00Total
Normal36716952062
APC-208208
Junctional premature-11
Junctional escape-212212
Total36721162483

Supraventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm49-8432 15:57
Atrial bigeminy57-983 1:28
SVTA121-1484 0:08
Atrial flutter123-14842 7:03
Atrial fibrillation69-16324 1:44
Nodal (junctional) rhythm47-12231 3:45

Signal qualityEpisodesDuration
Both clean8 29:10
Upper noisy3 0:08
Lower noisy1 0:05
Both noisy4 0:42

Notes:
The episodes of paroxysmal atrial flutter/fibrillation are usually followed by nodal escape beats. There are several intervals of high-frequency noise/artifact in both channels.

Points of interest:

6:45 Normal sinus rhythm
17:32 Atrial fibrillation
19:48 Atrial couplet
20:07 Atrial bigeminy
22:32 Paroxysmal atrial flutter, nodal rhythm
24:43 Noise
25:43 End of atrial flutter, nodal rhythm, normal sinus rhythm
26:09 Paroxysmal atrial flutter, nodal rhythm

Record 223 (MLII, V1; male, age 73)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal37316562029
APC76572
Aberrated APC-11
PVC18455473
Fusion PVC6814
Atrial escape21416
Total40621992605

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm75-9411 23:23
Ventricular bigeminy74-1067 4:19
Ventricular trigeminy67-923 0:38
Ventricular tachycardia76-1187 1:46

Signal qualityEpisodesDuration
Both clean5 28:41
Lower noisy5 1:20
Both noisy1 0:05

Notes:
The PVCs are multiform. The two longest episodes of ventricular tachycardia are slow (100 to 105 bpm) and bidirectional.

Points of interest:

9:35 Bidirectional ventricular tachycardia
12:35 Noise in lower signal
13:39 Atrial couplet
13:51 Ventricular bigeminy
17:21 Bidirectional ventricular tachycardia
17:55 End of ventricular tachycardia
19:07 APC, ventricular couplet, atrial escape beat, aberrated APC
23:58 Ventricular tachycardia, 3 beats
25:47 Ventricular tachycardia, 5 beats
29:16 APCs, atrial escape beat, ventricular couplets
29:51 Multiform ventricular couplets

Record 228 (MLII, V1; female, age 80)

Medications: Digoxin, Norpace

BeatsBefore 5:00After 5:00Total
Normal29013981688
APC-33
PVC60302362
Total35017032053

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm54-8021 24:17
Ventricular bigeminy50-8820 5:48

Signal qualityEpisodesDuration
Both clean11 28:25
Upper noisy10 1:40

Notes:
There is first degree AV block. The PVCs are multiform. There are three short occurrences of tape slippage with a maximum duration of 2.2 seconds.

Points of interest:

0:19 Ventricular bigeminy
0:38 Artifacts
0:50 PVC, ventricular couplet
4:35 Noise, PVCs
19:18 PVC, APC
20:08 Baseline noise
21:37 Tape slippage
21:49 Tape slippage
26:42 Ventricular bigeminy

Record 230 (MLII, V1; male, age 32)

Medications: Dilantin

BeatsBefore 5:00After 5:00Total
Normal39718582255
PVC-11
Total39718592256

RhythmRateEpisodesDuration
Normal sinus rhythm63-99104 17:45
Pre-excitation (WPW)59-93103 12:21

Signal qualityEpisodesDuration
Both clean2 30:03
Lower noisy1 0:03

Points of interest:

0:00 Onset of pre-excitation
0:12 End of pre-excitation (continued from previous strip)
5:11 WPW
9:26 Normal sinus rhythm
29:04 PVC

Record 231 (MLII, V1; female, age 72)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal12302314
Right BBB2789761254
APC1-1
PVC2-2
Blocked APC2-2
Total29512781573

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm49-696 18:26
2° heart block34-385 11:40

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
AV conduction is quite abnormal with periods of 2:1 AV block, examples of Mobitz II block, and right bundle branch block which appears to be rate-related. The couplet is probably ventricular.

Points of interest:

0:02 Normal sinus rhythm, Mobitz II block, right bundle branch block
2:24 Blocked APCs, APC, ventricular couplet
20:11 2:1 heart block with right bundle branch block
21:10 Onset of 2:1 heart block
23:22 Transition from 2:1 block with normal conduction to NSR with RBBB

Record 232 (MLII, V1; female, age 76)

Medications: Aldomet, Inderal

BeatsBefore 5:00After 5:00Total
Right BBB80317397
APC21511671382
Junctional escape-11
Total29514851780

Supraventricular ectopy

RhythmRateEpisodesDuration
Sinus bradycardia24-281 30:06

Signal qualityEpisodesDuration
Both clean14 26:38
Upper noisy6 1:24
Lower noisy10 1:14
Both noisy6 0:49

Notes:
The rhythm is compatible with sick sinus syndrome. There is underlying sinus bradycardia, first degree AV block, and frequent ectopic atrial runs at rates of 80 to 90 bpm. There are numerous long pauses up to 6 seconds in duration.

Points of interest:

0:58 Noise
1:51 Atrial couplets
11:51 Noise
13:06 Atrial couplets
15:09 Short runs of SVTA
18:17 SVTA, pause
22:31 Pauses
22:47 Pauses
23:20 Pauses
23:34 Pause
23:53 Sinus bradycardia

Record 233 (MLII, V1; male, age 57)

Medications: Dilantin

BeatsBefore 5:00After 5:00Total
Normal37118592230
APC347
PVC139692831
Fusion PVC5611
Total51825613079

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm98-11036 28:03
Ventricular bigeminy88-12228 1:48
Ventricular trigeminy106-1221 0:04
Ventricular tachycardia120-1416 0:11

Signal qualityEpisodesDuration
Both clean1 30:06

Notes:
The PVCs are multiform.

Points of interest:

0:11 APCs, PVCs
0:25 Ventricular tachycardia, 3 beats
2:18 Ventricular bigeminy
2:43 Fusion PVC/PVC couplet
3:39 Ventricular couplets
5:02 Transient amplitude decrease on upper signal
9:43 Ventricular tachycardia, 3 beats
16:20 PVCs, ventricular couplet
18:02 PVCs, APC
22:23 Ventricular tachycardia, 2 runs of 3 beats, ventricular couplets

Record 234 (MLII, V1; female, age 56)

Medications: None

BeatsBefore 5:00After 5:00Total
Normal46222382700
Junctional premature-5050
PVC-33
Total46222912753

Supraventricular ectopy

Ventricular ectopy

RhythmRateEpisodesDuration
Normal sinus rhythm84-992 29:40
SVTA91-1471 0:26

Signal qualityEpisodesDuration
Both clean4 28:40
Lower noisy4 1:18
Both noisy1 0:07

Notes:
The PVCs are uniform.

Points of interest:

0:16 Normal sinus rhythm
6:37 Noise
14:01 Onset of junctional tachycardia
14:26 End of junctional tachycardia
17:02 PVC
21:26 PVC
23:17 Noise

George B. Moody (george@mit.edu)

24 May 1997 (revised 24 June 2010)