12-Lead Electrocardiogram
Note: For screening there are only three rows. For sessions there are all of the five rows.
integer
Date of ECG
date
Time relative to dosing. The 12hrs and pre dose relative time are only for session 2-6, Screening only for session 1. Please choose "unscheduled" in case of additional, unplanned ECGs.
text
00:00-23:59
time
Ventricular rate
integer
PR interval
integer
QRS duration
integer
QT interval
integer
QTc interval
integer
ECG normal
boolean
ECG Abnormalities present
boolean
If abnormalities are present which are clinically significant, complete additional ECG ABNORMALITIES FORM. Copy the session number from the top of this form and the date and time to the ECG ABNORMALITIES FORM.
text