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3x4 Simultaneous ECG Report Patient Details Name: ID: Gender: Date of Birth: Height: Weight: Jill Simpson 123456789 Female 6/26/1970 (38 years) 5 ft 9 in 0 lbs Recording Details Recorded: Device: Location: 1/16/2009 4:03:25 PM CL 131568 Measurements Heart Rate: P Duration: PR Interval: QRS Duration: QT Interval: QTc Interval: P,QRS,T Axis: 60 bpm 76 ms 158 ms 92 ms 386 ms 386 ms 67°, 68°, 69° Interpretation (Unconfirmed) 004 Normal sinus rhythm 243 Ischemic ST-T changes in anterior leads 279 Poor R Progression in right precordial leads Comments: Scale: 25.0 mm/s 10.0 mm/mV 5mm/sqr. Filters: 0.05 - 150 Hz I II III aVR aVL aVF V1 V2 V3 V4 V5 V6 II Page 1 of 7 Printed: Monday, June 15, 2009 Data must be reviewed by a qualified physician. Copyright QRS Diagnostic

Universal ECG Sample Reports

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Page 1: Universal ECG Sample Reports

3x4 Simultaneous ECG ReportPatient DetailsName:ID:Gender:Date of Birth:Height:Weight:

Jill Simpson123456789Female6/26/1970 (38 years)5 ft 9 in0 lbs

Recording DetailsRecorded:Device:Location:

1/16/2009 4:03:25 PMCL 131568

MeasurementsHeart Rate:P Duration:PR Interval:QRS Duration:QT Interval:QTc Interval:P,QRS,T Axis:

60 bpm76 ms158 ms92 ms386 ms386 ms67°, 68°, 69°

Interpretation (Unconfirmed)004 Normal sinus rhythm243 Ischemic ST-T changes in anterior leads279 Poor R Progression in right precordial leads

Comments:

Scale: 25.0 mm/s 10.0 mm/mV 5mm/sqr. Filters: 0.05 - 150 Hz

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

II

Page 1 of 7 Printed: Monday, June 15, 2009

Data must be reviewed by a qualified physician.

Copyright QRS Diagnostic

Page 2: Universal ECG Sample Reports

3x4 Sequential ECG ReportPatient DetailsName:ID:Gender:Date of Birth:Height:Weight:

Jill Simpson123456789Female6/26/1970 (38 years)5 ft 9 in0 lbs

Recording DetailsRecorded:Device:Location:

1/16/2009 4:03:25 PMCL 131568

MeasurementsHeart Rate:P Duration:PR Interval:QRS Duration:QT Interval:QTc Interval:P,QRS,T Axis:

60 bpm76 ms158 ms92 ms386 ms386 ms67°, 68°, 69°

Interpretation (Unconfirmed)004 Normal sinus rhythm243 Ischemic ST-T changes in anterior leads279 Poor R Progression in right precordial leads

Comments:

Scale: 25.0 mm/s 10.0 mm/mV 5mm/sqr. Filters: 0.05 - 150 Hz

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

II

Page 2 of 7 Printed: Monday, June 15, 2009

Data must be reviewed by a qualified physician.

Copyright QRS Diagnostic

Page 3: Universal ECG Sample Reports

6x2 ECG ReportPatient DetailsName:ID:Gender:Date of Birth:Height:Weight:

Jill Simpson123456789Female6/26/1970 (38 years)5 ft 9 in0 lbs

Recording DetailsRecorded:Device:Location:

1/16/2009 4:03:25 PMCL 131568

MeasurementsHeart Rate:P Duration:PR Interval:QRS Duration:QT Interval:QTc Interval:P,QRS,T Axis:

60 bpm76 ms158 ms92 ms386 ms386 ms67°, 68°, 69°

Interpretation (Unconfirmed)004 Normal sinus rhythm243 Ischemic ST-T changes in anterior leads279 Poor R Progression in right precordial leads

Comments:

Scale: 25.0 mm/s 10.0 mm/mV 5mm/sqr. Filters: 0.05 - 150 Hz

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

Page 3 of 7 Printed: Monday, June 15, 2009

Data must be reviewed by a qualified physician.

Copyright QRS Diagnostic

Page 4: Universal ECG Sample Reports

6x1 ECG ReportPatient DetailsName:ID:Gender:Date of Birth:Height:Weight:

Jill Simpson123456789Female6/26/1970 (38 years)5 ft 9 in0 lbs

Recording DetailsRecorded:Device:Location:

1/16/2009 4:03:25 PMCL 131568

MeasurementsHeart Rate:P Duration:PR Interval:QRS Duration:QT Interval:QTc Interval:P,QRS,T Axis:

60 bpm76 ms158 ms92 ms386 ms386 ms67°, 68°, 69°

Interpretation (Unconfirmed)004 Normal sinus rhythm243 Ischemic ST-T changes in anterior leads279 Poor R Progression in right precordial leads

Comments:

Scale: 25.0 mm/s 10.0 mm/mV 5mm/sqr. Filters: 0.05 - 150 Hz

I

II

III

aVR

aVL

aVF

Page 4 of 7 Printed: Monday, June 15, 2009

Data must be reviewed by a qualified physician.

Copyright QRS Diagnostic

Page 5: Universal ECG Sample Reports

6x1 ECG ReportPatient DetailsName:ID:Gender:Date of Birth:Height:Weight:

Jill Simpson123456789Female6/26/1970 (38 years)5 ft 9 in0 lbs

Recording DetailsRecorded:Device:Location:

1/16/2009 4:03:25 PMCL 131568

MeasurementsHeart Rate:P Duration:PR Interval:QRS Duration:QT Interval:QTc Interval:P,QRS,T Axis:

60 bpm76 ms158 ms92 ms386 ms386 ms67°, 68°, 69°

Interpretation (Unconfirmed)004 Normal sinus rhythm243 Ischemic ST-T changes in anterior leads279 Poor R Progression in right precordial leads

Comments:

Scale: 25.0 mm/s 10.0 mm/mV 5mm/sqr. Filters: 0.05 - 150 Hz

V1

V2

V3

V4

V5

V6

Page 5 of 7 Printed: Monday, June 15, 2009

Data must be reviewed by a qualified physician.

Copyright QRS Diagnostic

Page 6: Universal ECG Sample Reports

ECG Measurements ReportPatient DetailsName:ID:Gender:Date of Birth:Height:Weight:

Jill Simpson123456789Female6/26/1970 (38 years)5 ft 9 in0 lbs

Recording DetailsRecorded:Device:Location:

1/16/2009 4:03:25 PMCL 131568

MeasurementsHeart Rate:P Duration:PR Interval:QRS Duration:QT Interval:QTc Interval:P,QRS,T Axis:

60 bpm76 ms158 ms92 ms386 ms386 ms67°, 68°, 69°

Interpretation (Unconfirmed)004 Normal sinus rhythm243 Ischemic ST-T changes in anterior leads279 Poor R Progression in right precordial leads

Comments:

| Amplitude (µV) | Slope (µV/s) | Duration (ms)Lead Type | P+ P- Q R S R' S' J ST20 ST60 ST80 T+ T- | ST | Q R S R' S'--------------------------------------------------------------------------------------------------------------------------------------I qrs | 73 0 -37 456 -141 0 0 -2 -1 1 10 114 0 -250 6 36 46 - - II qRs | 210 0 -147 1409 -447 0 0 -13 -9 -3 22 360 0 -250 10 34 46 - - III qRs | 138 0 -110 953 -306 0 0 -11 -8 -4 12 249 0 0 8 36 46 - - --------------------------------------------------------------------------------------------------------------------------------------

aVR rSr' | 0 -142 0 91 -933 293 0 7 4 0 -17 0 -237 250 - 8 36 46 - aVL rsr' | 0 -33 0 36 -248 83 0 4 3 2 -1 0 -68 -250 - 6 34 48 - aVF qRs | 173 0 -129 1181 -377 0 0 -13 -9 -4 16 302 0 -250 10 34 46 - - --------------------------------------------------------------------------------------------------------------------------------------

V1 rSr' | 0 -156 0 90 -967 297 0 7 4 0 -18 0 -263 -250 - 8 36 46 - V2 rSr' | 0 -198 0 113 -1205 367 0 9 7 1 -22 0 -309 0 - 10 34 46 - V3 rSr' | 0 -150 0 105 -943 310 0 9 5 -2 -14 0 -238 0 - 8 36 46 - --------------------------------------------------------------------------------------------------------------------------------------

V4 qrs | 69 0 -58 442 -151 0 0 -6 -3 -3 3 116 0 0 6 34 48 - - V5 qRs | 99 0 -92 680 -233 0 0 -10 -7 -5 8 178 0 0 8 36 46 - - V6 qRs | 101 0 -77 698 -223 0 0 -8 -6 -3 10 180 0 250 8 36 46 - - --------------------------------------------------------------------------------------------------------------------------------------

Page 7 of 7 Printed: Monday, June 15, 2009

Data must be reviewed by a qualified physician.

Copyright QRS Diagnostic