| 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? |
|
| 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 |