SUMMARY NOTES IN THE RECORD s20441  (Duration: 23:47:00.000)

Starting time, recording date:  09:44:00 08/01/1993

Lead 0: 0
Lead 1: 1

Age: 64  Sex: M
Comments: 
  Lead 0:
    There are 8 ischemic ST changes, generally associated
    with increases in heart rate.
  Lead 1:
    Fourteen episodes were present in this lead.
    NOTE - There is an axis shift in the QRS during the
    ischemic episode at 10:33:19, but it does not cause
    a significant ST change.
  Electrode locations were not recorded.
Symptoms during Holter recording: No data
Diagnoses: 
  Coronary artery disease
Treatment:
  Medications: 
    Nitroglycerine
    Calcium blocker
    Aspirin
  Balloon Angioplasty: No
  Coronary Artery bypass Grafting: No
History: 
  Previous myocardial infarction
  Hypertension: No
  Left ventricular hypertrophy: No data
  Cardiomyopathy: No data
  Valve disease: No data
  Electrolyte abnormalities: No data
  Hypercapnia, anemia, hypotension, hyperventilation: No data
  Atrioventricular nodal conduction delay: No data
  Intraventricular conduction block: No data
  Previous Myocardial Infarction: Yes
  Previous tests:
    ECG stress test: No data
    Thallium/Stress echo: No data
    Left ventricular function: No data
    Echocardiogram: No data
    Coronary Arteriography: 
      Lesions in right coronary artery, left anterior descending coronary artery, left circumflex coronary artery
    Baseline ECG: No data
Holter Recording:
  Date: 08/01/1993
  Recorder: No data


ST ANNOTATIONS

A. Criteria of 30 seconds and  75 microVolts (s20441.sta)

Lead 0:
Ischemic episodes:           8   Duration:      39:32   2.77% 
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:          14   Duration:    1:21:02   5.68% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                 4 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:          22   Duration:    2:00:34   4.22%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                 4 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          14   Duration:    1:21:30   5.71% 
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:        14   Duration:    1:21:30   5.71%
Unreadable intervals:        0   Duration:       0:00   0.00%

B. Criteria of 30 seconds and 100 microVolts (s20441.stb)

Lead 0:
Ischemic episodes:           5   Duration:      29:18   2.05% 
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:           8   Duration:    1:10:04   4.91% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                 4 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:          13   Duration:    1:39:22   3.48%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                 4 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:           8   Duration:    1:10:26   4.94% 
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:         8   Duration:    1:10:26   4.94%
Unreadable intervals:        0   Duration:       0:00   0.00%

C. Criteria of 60 seconds and 100 microVolts (s20441.stc)

Lead 0:
Ischemic episodes:           1   Duration:      15:28   1.08% 
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:           7   Duration:    1:08:06   4.77% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                 4 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:           8   Duration:    1:23:34   2.93%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                 4 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:           7   Duration:    1:08:06   4.77% 
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:         7   Duration:    1:08:06   4.77%
Unreadable intervals:        0   Duration:       0:00   0.00%


QRS ATRUTH ANNOTATIONS                   (s20441.atr)

Total number of beats                           93127

Normal beats                                    89666
Aberrated atrial premature beats                    2
Premature ventricular contractions               3436
Supraventricular premature or ectopic beats        23