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  1. StudyEvent: ADVL0212- Review Form (Dr. Chin)
    1. No Instruction available.
ECG Assessment
Beschrijving

ECG Assessment

Date of ECG
Beschrijving

Date of ECG

Datatype

date

Did patient experience any of the following: SVT, atrial fibrillation, or atrial flutter?
Beschrijving

Didpatientexperienceanyofthefollowing:SVT,atrialfibrillation,oratrialflutter?

Datatype

text

check all that apply
Beschrijving

checkallthatapply

Datatype

text

Did patient experience prolonged QTc compared to baseline?
Beschrijving

DidpatientexperienceprolongedQTccomparedtobaseline?

Datatype

text

check all that apply
Beschrijving

checkallthatapply

Datatype

text

Was there a T wave inversion in leads II, III, AVF (inferior leads) or V4, V5, and V6 (lateral leads)?
Beschrijving

WasthereaTwaveinversioninleadsII,III,AVF(inferiorleads)orV4,V5,andV6(lateralleads)?

Datatype

text

Was ST segment at the J-point greater than or equal to 2 mm below baseline in leads II, II AVF (inferior leads), V4, V5, V6 (lateral leads)?
Beschrijving

WasSTsegmentattheJ-pointgreaterthanorequalto2mmbelowbaselineinleadsII,IIAVF(inferiorleads),V4,V5,V6(lateralleads)?

Datatype

text

Did patient experience ventricular arrhythmia?
Beschrijving

Didpatientexperienceventriculararrhythmia?

Datatype

text

Ccrr Module For Advl0212- Review Form (dr. Chin)
Beschrijving

Ccrr Module For Advl0212- Review Form (dr. Chin)

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No Instruction available.

1 Formulieren
  1. StudyEvent: ADVL0212- Review Form (Dr. Chin)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
ECG Assessment
DateofECG
Item
Date of ECG
date
Item
Did patient experience any of the following: SVT, atrial fibrillation, or atrial flutter?
text
CL.1
Code List
Did patient experience any of the following: SVT, atrial fibrillation, or atrial flutter?
CL Item
Yes (Yes)
CL Item
No (No)
Item
check all that apply
text
CL.2
Code List
check all that apply
CL Item
SVT (SVT)
CL Item
Atrial fibrillation (Atrial fibrillation)
CL Item
Atrial flutter (Atrial flutter)
Item
Did patient experience prolonged QTc compared to baseline?
text
CL.3
Code List
Did patient experience prolonged QTc compared to baseline?
CL Item
Yes (Yes)
CL Item
No (No)
Item
check all that apply
text
CL.4
Code List
check all that apply
CL Item
To greater than or equal to 480 msec (To greater than or equal to 480 msec)
CL Item
Increase of greater than or equal to 50 msec (Increase of greater than or equal to 50 msec)
CL Item
Increase by 15 % (Increase by 15 %)
Item
Was there a T wave inversion in leads II, III, AVF (inferior leads) or V4, V5, and V6 (lateral leads)?
text
CL.5
Code List
Was there a T wave inversion in leads II, III, AVF (inferior leads) or V4, V5, and V6 (lateral leads)?
CL Item
Yes (Yes)
CL Item
No (No)
Item
Was ST segment at the J-point greater than or equal to 2 mm below baseline in leads II, II AVF (inferior leads), V4, V5, V6 (lateral leads)?
text
CL.6
Code List
Was ST segment at the J-point greater than or equal to 2 mm below baseline in leads II, II AVF (inferior leads), V4, V5, V6 (lateral leads)?
CL Item
Yes (Yes)
CL Item
No (No)
Item
Did patient experience ventricular arrhythmia?
text
CL.7
Code List
Did patient experience ventricular arrhythmia?
CL Item
Yes, change in VT (Yes, change in VT)
CL Item
Yes, change in VF (Yes, change in VF)
CL Item
Yes, change in both VT and VF (Yes, change in both VT and VF)
CL Item
No (No)
Item Group
Ccrr Module For Advl0212- Review Form (dr. Chin)
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