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<title>Sudden Cardiac Death Holter Database</title>
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<h1 align="center">The Sudden Cardiac Death Holter Database</h1>
<p>
<center><img src="/physiobank/charts/sddb.png"></center>
<p>
An estimated 400,000 Americans, and millions more worldwide, die suddenly each
year. These events are most often initiated with a sustained ventricular
tachyarrhythmia, including ventricular tachycardia (monomorphic or
polymorphic), ventricular flutter, or ventricular fibrillation, with a smaller
percentage related to a primary bradyarrhythmia. Sudden cardiac death syndrome
may be due to a wide variety of different electrical and mechanical substrates,
including acute myocardial infarction, chronic coronary disease with prior
myocardial infarction(s), cardiomyopathies, myocarditis, valvular heart
disease, right ventricular dysplasia, the long Q-T syndrome (acquired or
congenital), Wolff-Parkinson-White pre-excitation, the Brugada syndrome, drug
toxicity (e.g., proarrhythmic effects of cardioactive drugs; epinephrine,
cocaine, and related stimulants), and so forth. Moreover, some individuals
have no demonstrable electrical or mechanical predisposition.
<p>
PhysioNet has inaugurated a Sudden Cardiac Death Database to support research
and to stimulate progress in this important area of electrophysiology. We
initiate this database with 23 complete Holter recordings (originally collected
by Scott Greenwald while he was at MIT), from which half-hour excerpts have
been available to researchers since 1989 as the <a
href="/physiobank/database/vfdb/">MIT-BIH Malignant Ventricular Ectopy
Database</a>. The database currently includes 18 patients with underlying
sinus rhythm (4 with intermittent pacing), 1 who was continuously paced, and 4
with atrial fibrillation. All patients had a sustained ventricular
tachyarrhythmia, and most had an actual cardiac arrest.
<p>
These recordings were mainly obtained in the 1980s in Boston area hospitals,
and were later compiled as part of a study of ventricular arrhythmias. Because
of the retrospective nature of this collection, there are important
limitations. Patient information is limited, and sometimes completely
unavailable, including data regarding drug regimens and drug dosages. Further,
these cases may not be representative of spontaneous episodes of sudden death
in what is likely a very heterogenous group of subjects. Despite these
shortcomings, these unique recordings may provide important clues to the
pathogenesis of sudden death syndrome.
<p>
This is a small collection of an important type of data. The task of
annotating this database is particularly difficult because of the complexity of
the included cardiac rhythms. We invite the community to help us make this
collection larger, more representative, and more useful, and to annotate it
more thoroughly and rigorously. We welcome contributions of additional data
from other investigators who have access to similar records. We also invite
interested researchers to review and revise the annotation files provided for
these recordings; if you are interested in participating in this effort, please
<a href="mailto:webmaster@physionet.org?subject=SDDB Annotator
Inquiry">write</a> for additional information. We will gratefully acknowledge
all contributions.
<h2>References</h2>
<ul>
<li> Greenwald SD, Albrecht P, Moody GB, Mark RG. Estimating confidence limits
for arrhythmia detector performance. <i>Computers in Cardiology 1985</i>;
<b>12</b>:383-386.
<li> Greenwald SD. Development and analysis of a ventricular fibrillation
detector. M.S. thesis, MIT Dept. of Electrical Engineering and Computer
Science, 1986.
<li> Goldberger AL, Rigney DR, Mietus J, Antman EW, Greenwald S. Nonlinear
dynamics in sudden cardiac death syndrome: heart rate oscillations and
bifurcations. <i>Experientia</i> 1988; <b>44</b>:983-987.
[<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3197810" target="other">Abstract</a>]
(Analysis based on 16 subjects with underlying sinus rhythm.)
<li> Courtemanche M, Glass L. Rosengarten MD, Goldberger AL. Beyond pure
parasystole: promises and problems in modeling complex arrhythmias. <i>Am J
Physiol</i> 1989; <b>257</b> (Heart Circ Physiol 26):H693-H706.
[<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2764150" target="other">Abstract</a>]
(Case 2 in this report is based on data from record 47 of this database.)
<li> Goldberger AL, Rigney DR. On the non-linear motions of the heart:
fractals, chaos and cardiac dynamics. In: Goldbeter A, ed. <i>Cell to Cell
Signaling: From Experiments to Theoretical Models.</i> San Diego: Academic
Press, 1989, pp. 541-550. (Figure 4, showing complex periodic patterns of
ventricular premature beats, is derived from a record in this database.)
</ul>
<hr>
<h2>ECG data and beat annotations</h2>
<p>
A list in plain text form of the names of the records in this database can
be found <a href="RECORDS">here</a>.
<p>
<center>
<table border="0" cellspacing="1" cellpadding="3" width="720">
<tbody>
<tr bgcolor="cc9999">
<th align="center" width="13%">Signals</th>
<th align="center" width="13%">Header</th>
<th align="center" width="13%">Unaudited<br>Annotations</th>
<th align="center" width="13%">Audited<br>Annotations</th>
<th align="center" width="13%">Signal <br>Duration</th>
<th align="center" width="17%">VF Onset <br>Time (elapsed)</th>
<th align="center" width="18%">View <br> Waveform</th>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="30.dat">30.dat</a></td>
<td align="center"><a href="30.hea">30.hea</a></td>
<td align="center"><a href="30.ari">30.ari</a></td>
<td align="center"><a href="30.atr">30.atr</a></td>
<td align="center"> 24:33:17 </td>
<td align="center"> 07:54:33 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=30&tool=plot_waveforms&action=*&tstart=7:54:30&annotator=atr" target="other">30-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="31.dat">31.dat</a></td>
<td align="center"><a href="31.hea">31.hea</a></td>
<td align="center"><a href="31.ari">31.ari</a></td>
<td align="center"><a href="31.atr">31.atr</a></td>
<td align="center"> 13:58:40 </td>
<td align="center"> 13:42:24 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=31&tool=plot_waveforms&action=*&tstart=13:42:20&annotator=atr" target="other">31-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="32.dat">32.dat</a></td>
<td align="center"><a href="32.hea">32.hea</a></td>
<td align="center"><a href="32.ari">32.ari</a></td>
<td align="center"><a href="32.atr">32.atr</a></td>
<td align="center"> 24:20:00 </td>
<td align="center"> 16:45:18 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=32&tool=plot_waveforms&action=*&tstart=16:45:15&annotator=atr" target="other">32-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="33.dat">33.dat</a></td>
<td align="center"><a href="33.hea">33.hea</a></td>
<td align="center"><a href="33.ari">33.ari</a></td>
<td align="center"> </td>
<td align="center"> 24:33:00</td>
<td align="center"> 04:46:19 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=33&tool=plot_waveforms&action=*&tstart=04:46:15&annotator=ari" target="other">33-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="34.dat">34.dat</a></td>
<td align="center"><a href="34.hea">34.hea</a></td>
<td align="center"><a href="34.ari">34.ari</a></td>
<td align="center"><a href="34.atr">34.atr</a></td>
<td align="center"> 07:05:20 </td>
<td align="center"> 06:35:44 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=34&tool=plot_waveforms&action=*&tstart=06:35:40&annotator=atr" target="other">34-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="35.dat">35.dat</a></td>
<td align="center"><a href="35.hea">35.hea</a></td>
<td align="center"><a href="35.ari">35.ari</a></td>
<td align="center"><a href="35.atr">35.atr</a></td>
<td align="center"> 24:52:00 </td>
<td align="center"> 24:34:56 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=35&tool=plot_waveforms&action=*&tstart=24:34:50&annotator=atr" target="other">35-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="36.dat">36.dat</a></td>
<td align="center"><a href="36.hea">36.hea</a></td>
<td align="center"><a href="36.ari">36.ari</a></td>
<td align="center"><a href="36.atr">36.atr</a></td>
<td align="center"> 20:21:20 </td>
<td align="center"> 18:59:01 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=36&tool=plot_waveforms&action=*&tstart=18:58:55&annotator=atr" target="other">36-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="37.dat">37.dat</a></td>
<td align="center"><a href="37.hea">37.hea</a></td>
<td align="center"><a href="37.ari">37.ari</a></td>
<td align="center"> </td>
<td align="center"> 25:08:00 </td>
<td align="center"> 01:31:13 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=37&tool=plot_waveforms&action=*&tstart=01:31:10&annotator=ari" target="other">37-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="38.dat">38.dat</a></td>
<td align="center"><a href="38.hea">38.hea</a></td>
<td align="center"><a href="38.ari">38.ari</a></td>
<td align="center"> </td>
<td align="center"> 18:18:25 </td>
<td align="center"> 08:01:54 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=38&tool=plot_waveforms&action=*&tstart=08:01:50&annotator=ari" target="other">38-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="39.dat">39.dat</a></td>
<td align="center"><a href="39.hea">39.hea</a></td>
<td align="center"><a href="39.ari">39.ari</a></td>
<td align="center"> </td>
<td align="center"> 05:47:00 </td>
<td align="center"> 04:37:51 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=39&tool=plot_waveforms&action=*&tstart=04:37:45&annotator=ari" target="other">39-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="40.dat">40.dat</a></td>
<td align="center"><a href="40.hea">40.hea</a></td>
<td align="center"><a href="40.ari">40.ari</a></td>
<td align="center"> </td>
<td align="center"> 24:53:00 </td>
<td align="center"> (paced, no VF)</td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=40&tool=plot_waveforms&action=*&tstart=00:00:00&annotator=ari" target="other">40-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="41.dat">41.dat</a></td>
<td align="center"><a href="41.hea">41.hea</a></td>
<td align="center"><a href="41.ari">41.ari</a></td>
<td align="center"><a href="41.atr">41.atr</a></td>
<td align="center"> 03:56:00 </td>
<td align="center"> 02:59:24 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=41&tool=plot_waveforms&action=*&tstart=02:59:20&annotator=atr" target="other">41-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="42.dat">42.dat</a></td>
<td align="center"><a href="42.hea">42.hea</a></td>
<td align="center"><a href="42.ari">42.ari</a></td>
<td align="center"> </td>
<td align="center"> 25:08:10 </td>
<td align="center"> (no VF) </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=42&tool=plot_waveforms&action=*&tstart=00:00:00&annotator=ari" target="other">42-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="43.dat">43.dat</a></td>
<td align="center"><a href="43.hea">43.hea</a></td>
<td align="center"><a href="43.ari">43.ari</a></td>
<td align="center"> </td>
<td align="center"> 23:07:50 </td>
<td align="center"> 15:37:11 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=43&tool=plot_waveforms&action=*&tstart=15:37:05&annotator=ari" target="other">43-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="44.dat">44.dat</a></td>
<td align="center"><a href="44.hea">44.hea</a></td>
<td align="center"><a href="44.ari">44.ari</a></td>
<td align="center"> </td>
<td align="center"> 23:20:00 </td>
<td align="center"> 19:38:45 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=44&tool=plot_waveforms&action=*&tstart=19:38:40&annotator=ari" target="other">44-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="45.dat">45.dat</a></td>
<td align="center"><a href="45.hea">45.hea</a></td>
<td align="center"><a href="45.ari">45.ari</a></td>
<td align="center"><a href="45.atr">45.atr</a></td>
<td align="center"> 24:09:20 </td>
<td align="center"> 18:09:17 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=45&tool=plot_waveforms&action=*&tstart=18:09:10&annotator=atr" target="other">45-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="46.dat">46.dat</a></td>
<td align="center"><a href="46.hea">46.hea</a></td>
<td align="center"><a href="46.ari">46.ari</a></td>
<td align="center"><a href="46.atr">46.atr</a></td>
<td align="center"> 04:15:10 </td>
<td align="center"> 03:41:47 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=46&tool=plot_waveforms&action=*&tstart=03:41:40&annotator=atr" target="other">46-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="47.dat">47.dat</a></td>
<td align="center"><a href="47.hea">47.hea</a></td>
<td align="center"><a href="47.ari">47.ari</a></td>
<td align="center"> </td>
<td align="center"> 23:35:50 </td>
<td align="center"> 06:13:01 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=47&tool=plot_waveforms&action=*&tstart=06:12:55&annotator=ari" target="other">47-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="48.dat">48.dat</a></td>
<td align="center"><a href="48.hea">48.hea</a></td>
<td align="center"><a href="48.ari">48.ari</a></td>
<td align="center"> </td>
<td align="center"> 24:36:15 </td>
<td align="center"> 02:29:40 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=48&tool=plot_waveforms&action=*&tstart=02:29:35&annotator=ari" target="other">48-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="49.dat">49.dat</a></td>
<td align="center"><a href="49.hea">49.hea</a></td>
<td align="center"><a href="49.ari">49.ari</a></td>
<td align="center"><a href="49.atr">49.atr</a></td>
<td align="center"> 25:01:40 </td>
<td align="center"> (paced, no VF) </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=49&tool=plot_waveforms&action=*&tstart=13:42:20&annotator=atr" target="other">49-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="50.dat">50.dat</a></td>
<td align="center"><a href="50.hea">50.hea</a></td>
<td align="center"><a href="50.ari">50.ari</a></td>
<td align="center"> </td>
<td align="center"> 23:07:38 </td>
<td align="center"> 11:45:43 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=50&tool=plot_waveforms&action=*&tstart=11:45:40&annotator=ari" target="other">50-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="51.dat">51.dat</a></td>
<td align="center"><a href="51.hea">51.hea</a></td>
<td align="center"><a href="51.ari">51.ari</a></td>
<td align="center"><a href="51.atr">51.atr</a></td>
<td align="center"> 25:08:30 </td>
<td align="center"> 22:58:23 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=51&tool=plot_waveforms&action=*&tstart=22:58:20&annotator=atr" target="other">51-waveform</a></td>
</tr>
<tr bgcolor="88dddd">
<td align="center"><a href="52.dat">52.dat</a></td>
<td align="center"><a href="52.hea">52.hea</a></td>
<td align="center"><a href="52.ari">52.ari</a></td>
<td align="center"><a href="52.atr">52.atr</a></td>
<td align="center"> 07:31:05 </td>
<td align="center"> 02:32:40 </td>
<td align="center"><a href="/cgi-bin/ATM?database=sddb&record=52&tool=plot_waveforms&action=*&tstart=02:32:35&annotator=atr" target="other">52-waveform</a></td>
</tr>
</tbody>
</table>
</center>
<hr>
<h2>Clinical information</h2>
<p>
<center>
<table border="1" cellspacing="0" cellpadding="3" width="90%">
<tr bgcolor="dddddd">
<th align="center" width="10%"> Subject # </th>
<th align="center" width="8%"> Gender </th>
<th align="center" width="7%"> Age </th>
<th align="center" width="15%"> History </th>
<th align="center" width="25%"> Medication </th>
<th align="center" width="35%"> Underlying Cardiac Rhythm </th>
</tr>
<tr>
<td align="center">30</td>
<td align="center">Male</td>
<td align="center">43</td>
<td align="left"> Unknown</td>
<td align="left"> Unknown</td>
<td align="left"> Sinus</td>
</tr>
<tr>
<td align="center">31</td>
<td align="center">Female</td>
<td align="center">72</td>
<td align="left"> Heart failure</td>
<td align="left"> digoxin; quinidine gluconate</td>
<td align="left"> Sinus</td>
</tr>
<tr>
<td align="center">32</td>
<td align="center">Unknown</td>
<td align="center">62</td>
<td align="left"> Coronary bypass grafting; history of arrhythmia</td>
<td align="left"> Procan SR; beta-blocker</td>
<td align="left"> Sinus with intermittent demand ventricular pacing; CPR at time of cardiac arrest </td>
</tr>
<tr>
<td align="center">33</td>
<td align="center">Female</td>
<td align="center">30</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">34</td>
<td align="center">Male</td>
<td align="center">34</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">35</td>
<td align="center">Female</td>
<td align="center">72</td>
<td align="left"> Mitral valve replacement</td>
<td align="left"> digoxin </td>
<td align="left"> Atrial fibrillation</td>
</tr>
<tr>
<td align="center">36</td>
<td align="center">Male</td>
<td align="center">75</td>
<td align="left"> Cardiac surgery </td>
<td align="left"> digoxin; quinidine </td>
<td align="left"> Atrial fibrillation</td>
</tr>
<tr>
<td align="center">37</td>
<td align="center">Female</td>
<td align="center">89</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Atrial fibrillation</td>
</tr>
<tr>
<td align="center">38</td>
<td align="center">Unknown</td>
<td align="center">Unknown</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">39</td>
<td align="center">Male</td>
<td align="center">66</td>
<td align="left"> Acute myelogenous leukemia</td>
<td align="left"> digoxin; quinidine </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">40</td>
<td align="center">Male</td>
<td align="center">79</td>
<td align="left"> Unknown</td>
<td align="left"> Unknown</td>
<td align="left"> Paced </td>
</tr>
<tr>
<td align="center">41</td>
<td align="center">Male</td>
<td align="center">Unknown</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">42</td>
<td align="center">Male</td>
<td align="center">17</td>
<td align="left"> Hypertrophic cardiomyopathy; positive family history of sudden death </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
</tr>
<tr>
<td align="center">43</td>
<td align="center">Male</td>
<td align="center">35</td>
<td align="left"> Coronary artery disease</td>
<td align="left"> Unknown </td>
<td align="left"> Intermittent ventricular pacing </td>
</tr>
<tr>
<td align="center">44</td>
<td align="center">Male</td>
<td align="center">Unknown</td>
<td align="left"> Unknown</td>
<td align="left"> Unknown</td>
<td align="left"> Sinus</td>
</tr>
<tr>
<td align="center">45</td>
<td align="center">Male</td>
<td align="center">68</td>
<td align="left"> History of ventricular ectopy</td>
<td align="left"> digoxin; quinidine gluconate </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">46</td>
<td align="center">Female</td>
<td align="center">Unknown</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">47</td>
<td align="center">Male</td>
<td align="center">34</td>
<td align="left"> Unknown</td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">48</td>
<td align="center">Male</td>
<td align="center">80</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus </td>
</tr>
<tr>
<td align="center">49</td>
<td align="center">Male</td>
<td align="center">73</td>
<td align="left"> Coronary artery s/p myocardial infarction; history of ventricular tachycardia</td>
<td align="left"> Unknown </td>
<td align="left"> Sinus with intermittent pacing</td>
</tr>
<tr>
<td align="center">50</td>
<td align="center">Female</td>
<td align="center">68</td>
<td align="left"> Coronary artery bypass graft; mitral valve replacement </td>
<td align="left"> digoxin; quinidine; propranolol; potassium; diuretics</td>
<td align="left"> Atrial fibrillation</td>
</tr>
<tr>
<td align="center">51</td>
<td align="center">Female</td>
<td align="center">67</td>
<td align="left"> Unknown </td>
<td align="left"> Unknown </td>
<td align="left"> Sinus with intermittent pacing </td>
</tr>
<tr>
<td align="center">52</td>
<td align="center">Female</td>
<td align="center">82</td>
<td align="left"> Heart failure</td>
<td align="left"> None listed </td>
<td align="left"> Sinus </td>
</tr>
</table>
</center>
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