Electrocardiogram - TIG


This example shows a CRF that collects electrocardiogram data utilizing a local reader.



"Tobacco Implementation Guide-ECG- Local Reading [TIG_EG_LOCAL]" Form Preview
Tobacco Implementation Guide-ECG- Local Reading
ECG - Local Reading
Was the ECG performed? Yes  No  
What was the method used for the ECG? 12 LEAD STANDARD  HOLTER CONTINUOUS ECG RECORDING  
What was the position of the subject during the ECG measurement?
What was the date of the ECG?
 01 Jan 2000
ECG Mean Heart Rate Result
Unit
QRS Duration, Aggregate Result
Unit
PR Interval, Single Beat Result
Unit
QT Interval, Aggregate Result
Unit
QTca Interval, Aggregate Result
Unit
Interpretation Normal  Abnormal  
Was the ECG clinically significant? Yes  No  
* Mandatory field

Package(s)
TIG_eCRF_Package_Electrocardiogram