SUMMARY NOTES IN THE RECORD s20541 (Duration: 22:59:00.000)
Starting time, recording date: 12:13:00 27/09/1999
Lead 0: V4
Lead 1: MLIII
Age: 23 Sex: F
Comments:
This unusual record demonstrates intermittent pre-excitation that
results in considerable variability of the ST segment. During
pre-excitation there is a depression in the ST segment. When alteration
in the conduction pattern is rapid, the average ST segment as displayed
by SEMIA shows minimal sustained change. When conduction shifts and
remains consistent for minutes, then the ST segment changes significantly.
To make matters more complicated, the degree of pre-excitation often
varies, producing intermediate QRS and ST morphological forms. This
record shows some rate-related episodes.
Symptoms during Holter recording: No data
Diagnoses:
Wolf-Parkinson-White (WPW) syndrome
Treatment:
Medications: No
Balloon Angioplasty: No data
Coronary Artery bypass Grafting: No data
History:
Palpitations
Hypertension: No
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, but intermittent pre-excitation
Previous Myocardial Infarction: No
Previous tests:
ECG stress test: No
Thallium/Stress echo: No data
Left ventricular function:
Normal
Echocardiogram: No data
Coronary Arteriography: No
Baseline ECG:
WPW (short PR interval and delta wave)
Holter Recording:
Date: 27/09/1999
Recorder: Remco
ST ANNOTATIONS
A. Criteria of 30 seconds and 75 microVolts (s20541.sta)
Lead 0:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 11 Duration: 1:27:40 6.36%
Axis shifts: 0
Conduction-change shifts: 281
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 5 Duration: 47:02 3.41%
Axis shifts: 0
Conduction-change shifts: 148
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 16 Duration: 2:14:42 4.88%
Axis shifts: 0
Conduction-change shifts: 429
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 11 Duration: 1:28:26 6.41%
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined [ischemic or rate-related]:
ST segment episodes: 11 Duration: 1:28:26 6.41%
Unreadable intervals: 0 Duration: 0:00 0.00%
B. Criteria of 30 seconds and 100 microVolts (s20541.stb)
Lead 0:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 9 Duration: 1:15:00 5.44%
Axis shifts: 0
Conduction-change shifts: 281
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 4 Duration: 40:50 2.96%
Axis shifts: 0
Conduction-change shifts: 148
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 13 Duration: 1:55:50 4.20%
Axis shifts: 0
Conduction-change shifts: 429
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 9 Duration: 1:15:40 5.49%
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined [ischemic or rate-related]:
ST segment episodes: 9 Duration: 1:15:40 5.49%
Unreadable intervals: 0 Duration: 0:00 0.00%
C. Criteria of 60 seconds and 100 microVolts (s20541.stc)
Lead 0:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 6 Duration: 1:06:22 4.81%
Axis shifts: 0
Conduction-change shifts: 281
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Lead 1:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 3 Duration: 23:04 1.67%
Axis shifts: 0
Conduction-change shifts: 148
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Total:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 9 Duration: 1:29:26 3.24%
Axis shifts: 0
Conduction-change shifts: 429
Noisy events: 0
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined:
Ischemic episodes: 0 Duration: 0:00 0.00%
Rate-related episodes: 6 Duration: 1:07:02 4.86%
Unreadable intervals: 0 Duration: 0:00 0.00%
Combined [ischemic or rate-related]:
ST segment episodes: 6 Duration: 1:07:02 4.86%
Unreadable intervals: 0 Duration: 0:00 0.00%
QRS ATRUTH ANNOTATIONS (s20541.atr)
Total number of beats 115151
Normal beats 114577
Aberrated atrial premature beats 1
Premature ventricular contractions 563
Fusions of ventricular and normal beat 5
Supraventricular premature or ectopic beats 4
Paced beats 1