SUMMARY NOTES IN THE RECORD s30681 (Duration: 23:39:35.984) Starting time, recording date: 11:35:00 14/01/1999 Lead 0: V6 Lead 1: II Lead 2: V5 Age: 71 Sex: M Comments: Patient with CAD and hypertension has many episodes of ST depression recorded simultaneously on all leads. The ST segments are associated with heart rate increases, and with different ST shape. Most are J-point depressions with up-sloping ST segments, but a very convincing episode occurred at the end of the recording period with clearly ischemic, down-sloping ST segments. Symptoms during Holter recording: None reported Diagnoses: Coronary artery disease Mild hypertension Treatment: Medications: Nifedipine Atenolol Procardia Isordil Nitroglycerine Balloon Angioplasty: No Coronary Artery bypass Grafting: No History: Positive exercise tolerance test in 1983. No catheterization or coronary artery bypass grafting Hypertension: Yes Left ventricular hypertrophy: no data 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: Yes Date: 1983 Findings: ST depression >2mm, peak HR=136. ST changes in leads II, III, V3-V6 Thallium/Stress echo: Normal Left ventricular function: No data Echocardiogram: No data Coronary Arteriography: No data Baseline ECG: No data Holter Recording: Date: 14/01/1999 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30681.sta) Lead 0: Ischemic episodes: 26 Duration: 5:19:10 22.48% 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: 11 Duration: 4:04:08 17.20% 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 2: Ischemic episodes: 30 Duration: 5:50:26 24.69% 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% Total: Ischemic episodes: 67 Duration: 15:13:44 21.46% 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% Combined: Ischemic episodes: 29 Duration: 6:08:30 25.96% 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: 29 Duration: 6:08:30 25.96% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s30681.stb) Lead 0: Ischemic episodes: 11 Duration: 4:36:50 19.50% 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: 3:51:56 16.34% 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 2: Ischemic episodes: 17 Duration: 5:26:52 23.03% 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% Total: Ischemic episodes: 35 Duration: 13:55:38 19.62% 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% Combined: Ischemic episodes: 15 Duration: 5:37:26 23.77% 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: 15 Duration: 5:37:26 23.77% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s30681.stc) Lead 0: Ischemic episodes: 8 Duration: 4:31:36 19.13% 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: 6 Duration: 3:48:18 16.08% 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 2: Ischemic episodes: 11 Duration: 5:05:36 21.53% 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% Total: Ischemic episodes: 25 Duration: 13:25:30 18.91% 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% Combined: Ischemic episodes: 9 Duration: 5:16:10 22.27% 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: 9 Duration: 5:16:10 22.27% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s30681.atr) Total number of beats 126651 Normal beats 126606 Premature ventricular contractions 15 Supraventricular premature or ectopic beats 30