SUMMARY NOTES IN THE RECORD s30721 (Duration: 23:33:46.000) Starting time, recording date: 11:13:00 19/01/2000 Lead 0: E-S Lead 1: A-S Lead 2: A-I Age: 85 Sex: F Comments: This record shows intraventricular conduction defects (probably RBBB), normal sinus rhythm, and both rate- related and ischemic episodes. Two rate-related episodes occured in lead 0, one at the beginning and one at the end of the record. There were no significant changes in leads 1 and 2 at these times. There were also several clear-cut ischemic episodes, revealed primarily in leads 1 and 2. These episodes were further complicated by conduction changes probably associated with the ischemic process. Symptoms during Holter recording: None reported Diagnoses: Coronary artery disease Hyperlipidemia Osteoarthritis Treatment: Medications: Aspirin Lipitor Balloon Angioplasty: No Coronary Artery bypass Grafting: Yes, five grafts 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: Probably, based on abnormal wall motion. Previous tests: ECG stress test: Yes Date: January, 2000 Findings: Negative for ST changes with inadequate heart rate Thallium/Stress echo: Fixed minor wall motiion abnormalities - inferior, posterior, and septal walls. Left ventricular function: Ejection fraction 48% Echocardiogram: No data Coronary Arteriography: Yes, results unavailable Baseline ECG: No data Holter Recording: Date: 19/01/2000 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30721.sta) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 2 Duration: 39:44 2.81% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 4:06 0.29% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 7 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 1 Duration: 4:02 0.29% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 5 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 2 Duration: 8:08 0.19% Rate-related episodes: 2 Duration: 39:44 0.94% Axis shifts: 0 Conduction-change shifts: 12 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 1 Duration: 4:08 0.29% Rate-related episodes: 2 Duration: 39:44 2.81% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 3 Duration: 43:52 3.10% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s30721.stb) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 1 Duration: 29:32 2.09% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 4:06 0.29% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 7 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 5 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 1 Duration: 4:06 0.10% Rate-related episodes: 1 Duration: 29:32 0.70% Axis shifts: 0 Conduction-change shifts: 12 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 1 Duration: 4:06 0.29% Rate-related episodes: 1 Duration: 29:32 2.09% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 2 Duration: 33:38 2.38% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s30721.stc) Lead 0: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 1 Duration: 29:32 2.09% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 4:06 0.29% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 7 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 0 Duration: 0:00 0.00% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 5 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 1 Duration: 4:06 0.10% Rate-related episodes: 1 Duration: 29:32 0.70% Axis shifts: 0 Conduction-change shifts: 12 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 1 Duration: 4:06 0.29% Rate-related episodes: 1 Duration: 29:32 2.09% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 2 Duration: 33:38 2.38% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s30721.atr) Total number of beats 106636 Normal beats 103894 Premature ventricular contractions 335 Supraventricular premature or ectopic beats 2407