SUMMARY NOTES IN THE RECORD s20161  (Duration: 23:44:01.000)

Starting time, recording date:  14:36:00 01/12/1986

Lead 0: MLIII
Lead 1: V4

Age: 65  Sex: M
Comments: 
  This patient has Prinzmetal's angina, with episodes of
  major ST elevation in lead 0. In lead 1 the corresponding
  changes are ST depressions. Of interest, the QRS morphology
  changes slightly during the ischemic episodes, possibly
  due to transient chamber enlargement (Bradie effect). The
  time course of the morphology change is gradual, as opposed
  to the sudden axis shifts characteristic of postural
  changes.
  An excerpt of this recording is included in the European
  ST-T Database (record e0105).
Symptoms during Holter recording: No data
Diagnoses: 
  Prinzmetal's angina
  Coronary artery disease 
Treatment:
  Medications: 
    Verapamil
  Balloon Angioplasty: No data
  Coronary Artery bypass Grafting: No data
History: 
  Hypertriglyceridemia, coronary artery disease, previous myocardial infarction
  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
  Previous Myocardial Infarction: Yes, inferior
  Previous tests:
    ECG stress test: yes
      Date: No Data
      Findings: Positive - ST depression in leads II, III, avF, and V5-V6
    Thallium/Stress echo: No data
    Left ventricular function: 
      Globally normal
    Echocardiogram: No data
    Coronary Arteriography: 
      Right coronary artery occlusion, 50% stenosis of left anterior descending coronary artery, 95% stenosis of left circumflex artery
    Baseline ECG: 
      Inferior negative T waves
      No arrhythmias
Holter Recording:
  Date: 01/12/1986
  Recorder: ICR


ST ANNOTATIONS

A. Criteria of 30 seconds and  75 microVolts (s20161.sta)

Lead 0:
Ischemic episodes:          59   Duration:    4:18:58  18.19% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                16 
Conduction-change shifts:    0 
Noisy events:                1 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Lead 1:
Ischemic episodes:          10   Duration:      37:24   2.63% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                 2 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:          69   Duration:    4:56:22  10.41%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                18 
Conduction-change shifts:    0 
Noisy events:                1 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          59   Duration:    4:19:24  18.22% 
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:        59   Duration:    4:19:24  18.22%
Unreadable intervals:        0   Duration:       0:00   0.00%

B. Criteria of 30 seconds and 100 microVolts (s20161.stb)

Lead 0:
Ischemic episodes:          41   Duration:    3:49:50  16.14% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                16 
Conduction-change shifts:    0 
Noisy events:                1 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Lead 1:
Ischemic episodes:           3   Duration:      17:18   1.21% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                 2 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:          44   Duration:    4:07:08   8.68%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                18 
Conduction-change shifts:    0 
Noisy events:                1 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          41   Duration:    3:50:16  16.17% 
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:        41   Duration:    3:50:16  16.17%
Unreadable intervals:        0   Duration:       0:00   0.00%

C. Criteria of 60 seconds and 100 microVolts (s20161.stc)

Lead 0:
Ischemic episodes:          32   Duration:    3:27:32  14.57% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                16 
Conduction-change shifts:    0 
Noisy events:                1 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Lead 1:
Ischemic episodes:           3   Duration:      17:18   1.21% 
Rate-related episodes:       0   Duration:       0:00   0.00% 
Axis shifts:                 2 
Conduction-change shifts:    0 
Noisy events:                0 
Unreadable intervals:        0   Duration:       0:00   0.00% 

Total:
Ischemic episodes:          35   Duration:    3:44:50   7.89%
Rate-related episodes:       0   Duration:       0:00   0.00%
Axis shifts:                18 
Conduction-change shifts:    0 
Noisy events:                1 
Unreadable intervals:        0   Duration:       0:00   0.00%

Combined:
Ischemic episodes:          32   Duration:    3:27:58  14.60% 
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:        32   Duration:    3:27:58  14.60%
Unreadable intervals:        0   Duration:       0:00   0.00%


QRS ATRUTH ANNOTATIONS                   (s20161.atr)

Total number of beats                           83698

Normal beats                                    83671
Premature ventricular contractions                  8
Fusions of ventricular and normal beat              1
Supraventricular premature or ectopic beats        18