SUMMARY NOTES IN THE RECORD s30771 (Duration: 16:53:20.000) Starting time, recording date: 20:16:00 08/11/1999 Lead 0: E-S Lead 1: A-S Lead 2: A-I Age: 75 Sex: F Comments: The record shows ischemic ST depressions in all three leads which are associated with increased heart rate. In lead 2, during the first six and a half hours, there are also ST elevations recognized as rate-related episodes. Symptoms during Holter recording: None reported Diagnoses: Coronary artery disease Previous myocardial infarction Treatment: Medications: Atenolol Aspirin Pravachol Balloon Angioplasty: No Coronary Artery bypass Grafting: No History: Coronary artery disease, old myocardial infarction Hypertension: No Left ventricular hypertrophy: No Cardiomyopathy: No data Valve disease: No data Electrolyte abnormalities: No data Hypercapnia, anemia, hypotension, hyperventilation: No data Atrioventricular nodal conduction delay: No Intraventricular conduction block: No Previous Myocardial Infarction: Yes, in 1997 Previous tests: ECG stress test: Yes Date: October, 1997 Findings: Lateral precordial ST depression - positive test Thallium/Stress echo: Infero-apical dyskinesia with exercise. Left ventricular function: Ejection fraction 50% Echocardiogram: No data Coronary Arteriography: Lesions in left anterior descending coronary artery, right coronary artery, left circumflex coronary artery Baseline ECG: Normal sinus rhythm, non-specific ST-T changes in inferior leads and V6. Holter Recording: Date: 08/11/1999 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30771.sta) Lead 0: Ischemic episodes: 3 Duration: 14:46 1.46% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 9 Duration: 54:30 5.38% 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% Lead 2: Ischemic episodes: 9 Duration: 59:22 5.86% Rate-related episodes: 6 Duration: 19:34 1.93% Axis shifts: 9 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 21 Duration: 2:08:38 4.23% Rate-related episodes: 6 Duration: 19:34 0.64% Axis shifts: 17 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 14 Duration: 1:30:00 8.88% Rate-related episodes: 5 Duration: 4:44 0.47% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 16 Duration: 1:34:44 9.35% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s30771.stb) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 4 Duration: 44:24 4.38% 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% Lead 2: Ischemic episodes: 4 Duration: 37:56 3.74% Rate-related episodes: 3 Duration: 6:22 0.63% Axis shifts: 9 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 8 Duration: 1:22:20 2.71% Rate-related episodes: 3 Duration: 6:22 0.21% Axis shifts: 17 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 6 Duration: 1:03:52 6.30% Rate-related episodes: 3 Duration: 6:22 0.63% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 9 Duration: 1:10:14 6.93% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s30771.stc) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 3 Duration: 43:34 4.30% 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% Lead 2: Ischemic episodes: 1 Duration: 18:30 1.83% Rate-related episodes: 1 Duration: 3:38 0.36% Axis shifts: 9 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 4 Duration: 1:02:04 2.04% Rate-related episodes: 1 Duration: 3:38 0.12% Axis shifts: 17 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 3 Duration: 44:26 4.38% Rate-related episodes: 1 Duration: 3:38 0.36% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 4 Duration: 48:04 4.74% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s30771.atr) Total number of beats 78073 Normal beats 74811 Premature ventricular contractions 6 Atrial premature beats 3248 Atrial escape beats 8