SUMMARY NOTES IN THE RECORD s20274  (Duration: 22:56:08.000)

Starting time, recording date:  13:15:00 11/09/1992

Lead 0: 0
Lead 1: 1

Age: 61  Sex: M
Comments:
  Records s20271, s20272, s20273 and s20274 are from the same patient.
  This is the final record.
  The onset of ischemia often begins with peaking of T-waves,
  followed by ST depression. Rate increases often lead to
  ischemic changes sometimes only T-wave peaking, and sometimes
  also ST depression.
  Lead 0:
    It is easier to annotate since the ST deviation function has
    less variability.
  Lead 1:
    It is more difficult because of its higher variability compound
    to ischemic episodes. There are regions particularly seen in
    lead 1 after ischemia to the end of the record, where there are
    numerous ST shifts, generally associated with heart rate changes,
    which are felt to be manifestations of ischemia - some T-wave
    peaking, some ST depressions.               
  Electrode locations were not recorded. 
Symptoms during Holter recording: No data
Diagnoses: 
  Coronary artery disease
Treatment:
  Medications: 
    Isordil
    Nitroglycerine
    Calcium channel blocker
    Aspirin
  Balloon Angioplasty: Yes
  Coronary Artery bypass Grafting: No
History: 
  Angina
  Hypertension: No
  Left ventricular hypertrophy: No
  Cardiomyopathy: No
  Valve disease: No
  Electrolyte abnormalities: No
  Hypercapnia, anemia, hypotension, hyperventilation: No
  Atrioventricular nodal conduction delay: No data
  Intraventricular conduction block: No data
  Previous Myocardial Infarction: No
  Previous tests:
    ECG stress test: No data
    Thallium/Stress echo: No data
    Left ventricular function: No data
    Echocardiogram: No data
    Coronary Arteriography: 
      Lesions in left anterior descending coronary artery, left circumflex coronary artery
    Baseline ECG: No data
Holter Recording:
  Date: 11/09/1992
  Recorder: No data


ST ANNOTATIONS

A. Criteria of 30 seconds and  75 microVolts (s20274.sta)

Lead 0:
Ischemic episodes:          55   Duration:    4:19:56  18.89% 
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:          88   Duration:    8:03:34  35.14% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                15 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:         143   Duration:   12:23:30  27.01%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                15 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          88   Duration:    8:10:06  35.61% 
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:        88   Duration:    8:10:06  35.61%
Unreadable intervals:        0   Duration:       0:00   0.00%

B. Criteria of 30 seconds and 100 microVolts (s20274.stb)

Lead 0:
Ischemic episodes:          39   Duration:    3:41:24  16.09% 
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:          63   Duration:    7:11:26  31.35% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                15 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:         102   Duration:   10:52:50  23.72%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                15 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          63   Duration:    7:17:32  31.79% 
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:        63   Duration:    7:17:32  31.79%
Unreadable intervals:        0   Duration:       0:00   0.00%

C. Criteria of 60 seconds and 100 microVolts (s20274.stc)

Lead 0:
Ischemic episodes:          33   Duration:    3:25:08  14.91% 
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:          44   Duration:    6:26:26  28.08% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                15 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:          77   Duration:    9:51:34  21.49%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                15 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          45   Duration:    6:34:32  28.67% 
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:        45   Duration:    6:34:32  28.67%
Unreadable intervals:        0   Duration:       0:00   0.00%


QRS ATRUTH ANNOTATIONS                   (s20274.atr)

Total number of beats                          121061

Normal beats                                   120351
Premature ventricular contractions                702
Fusions of ventricular and normal beat              2
Supraventricular premature or ectopic beats         6