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Ecganalysisreport 2
Ecganalysisreport 2
Sponsor:
Protocol:
Account:
Transmittal Number:
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 1 / DAY 15 / PRE DOSE
20-AUG-2015
10:19:00
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
58
Comparator
(3 of 3)
Mean
61
Change
-3
RR Interval (ms) :
1043
985
58
PR Interval (ms) :
141
131
10
79
84
-5
423
406
17
417
408
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947859
COLLECTED: 20-AUG-2015
10:19:00
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 7 / DAY 15 / PRE DOSE
22-DEC-2015
09:39:40
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
58
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1040
N/A
N/A
PR Interval (ms) :
141
N/A
N/A
71
N/A
N/A
386
N/A
N/A
381
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947870
COLLECTED: 22-DEC-2015
09:39:40
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 5 / DAY 15 / 1.5 POST DOSE
17-FEB-2016
16:01:50
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
05-OCT-1939
5009003
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
66
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
911
N/A
N/A
PR Interval (ms) :
208
N/A
N/A
95
N/A
N/A
413
N/A
N/A
426
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:20 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947834
COLLECTED: 17-FEB-2016
16:01:50
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 2 / DAY 1 / 1.5 POST DOSE
02-FEB-2016
10:13:38
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
63
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
949
N/A
N/A
PR Interval (ms) :
155
N/A
N/A
73
N/A
N/A
410
N/A
N/A
417
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947844
COLLECTED: 02-FEB-2016
10:13:38
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 2 / DAY 15 / PRE DOSE
16-FEB-2016
10:38:45
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
68
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
884
N/A
N/A
PR Interval (ms) :
165
N/A
N/A
72
N/A
N/A
405
N/A
N/A
422
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947842
COLLECTED: 16-FEB-2016
10:38:45
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
UNSCHEDULED 1.5 POSTDOSE
17-SEP-2015
11:03:17
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
57
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1047
N/A
N/A
PR Interval (ms) :
151
N/A
N/A
93
N/A
N/A
408
N/A
N/A
402
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: PART 1 CYCLE 2 / DAY 21 / 1.5 POST DOSE
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947864
COLLECTED: 17-SEP-2015
11:03:17
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 2 / DAY 8 / 1.5 POST DOSE
08-DEC-2015
11:58:06
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
05-OCT-1939
5009003
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
73
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
821
N/A
N/A
PR Interval (ms) :
205
N/A
N/A
98
N/A
N/A
384
N/A
N/A
410
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:20 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947837
COLLECTED: 08-DEC-2015
11:58:06
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 2 / DAY 15 / LEE011 4 POST
DOSE
16-FEB-2016
14:26:21
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Comparator
Mean
N/A
Change
N/A
871
N/A
N/A
154
N/A
N/A
81
N/A
N/A
QT Interval (ms) :
424
N/A
N/A
444
N/A
N/A
Lead Analyzed: II
Heart Rate (bpm) :
Mean
69
RR Interval (ms) :
PR Interval (ms) :
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947840
COLLECTED: 16-FEB-2016
14:26:21
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 2 / DAY 8 / 1.5 POST DOSE
03-SEP-2015
10:59:50
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
62
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
973
N/A
N/A
PR Interval (ms) :
144
N/A
N/A
91
N/A
N/A
400
N/A
N/A
404
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947862
COLLECTED: 03-SEP-2015
10:59:50
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 3 / DAY 15 / PRE DOSE
04-JAN-2016
14:36:26
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
68
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
877
N/A
N/A
PR Interval (ms) :
195
N/A
N/A
86
N/A
N/A
407
N/A
N/A
425
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:20 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947835
COLLECTED: 04-JAN-2016
14:36:26
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 2 / DAY 8 / PRE DOSE
11-DEC-2015
11:33:14
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
56
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1078
N/A
N/A
PR Interval (ms) :
191
N/A
N/A
73
N/A
N/A
444
N/A
N/A
433
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947855
COLLECTED: 11-DEC-2015
11:33:14
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 2 / DAY 21 / PRE DOSE
17-SEP-2015
09:30:43
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
55
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1085
N/A
N/A
PR Interval (ms) :
137
N/A
N/A
75
N/A
N/A
422
N/A
N/A
411
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947865
COLLECTED: 17-SEP-2015
09:30:43
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 11 / DAY 15 / 1.5 POST DOSE
10-MAR-2016
13:03:23
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
60
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1004
N/A
N/A
PR Interval (ms) :
147
N/A
N/A
76
N/A
N/A
415
N/A
N/A
415
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947877
COLLECTED: 10-MAR-2016
13:03:23
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 21 / LEE011_PRE
DOSE
27-JAN-2016
10:15:24
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
57
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
66
Change
-9
1047
913
134
175
177
-2
75
82
-7
QT Interval (ms) :
415
432
-17
408
445
-37
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947847
COLLECTED: 27-JAN-2016
10:15:24
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 5 / DAY 15 / 1.5 POST DOSE
19-NOV-2015
13:58:53
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
59
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1013
N/A
N/A
PR Interval (ms) :
140
N/A
N/A
76
N/A
N/A
393
N/A
N/A
392
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947869
COLLECTED: 19-NOV-2015
13:58:53
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 1 / DAY 15 / 1.5 POST DOSE
25-NOV-2015
16:15:17
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
60
Comparator
(3 of 3)
Mean
63
Change
-3
RR Interval (ms) :
992
948
44
PR Interval (ms) :
174
170
81
86
-5
433
420
13
434
427
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947857
COLLECTED: 25-NOV-2015
16:15:17
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 11 / DAY 15 / PREDOSE
10-MAR-2016
11:32:19
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
65
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
917
N/A
N/A
PR Interval (ms) :
139
N/A
N/A
83
N/A
N/A
404
N/A
N/A
416
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947876
COLLECTED: 10-MAR-2016
11:32:19
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 END OF TREAMTENT
01-MAR-2016
11:04:19
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
70
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
861
N/A
N/A
PR Interval (ms) :
166
N/A
N/A
75
N/A
N/A
417
N/A
N/A
439
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:19 ET
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947839
COLLECTED: 01-MAR-2016
11:04:19
Page 2 of 2
Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 9 / DAY 15 / 1.5 POST DOSE
04-FEB-2016
12:30:15
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
7 Digit Subject Number:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
56
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1067
N/A
N/A
PR Interval (ms) :
147
N/A
N/A
85
N/A
N/A
418
N/A
N/A
409
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: PART 1 CYCLE 9 / DAY 15 / PRE DOSE
Date: ____________________________
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947871
COLLECTED: 04-FEB-2016
12:30:15
Page 2 of 2
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
UNSCHEDULED PREDOSE
05-AUG-2015
08:49:32
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
57
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1048
N/A
N/A
PR Interval (ms) :
143
N/A
N/A
77
N/A
N/A
395
N/A
N/A
389
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: PART 1 CYCLE 1 / DAY 1 / PRE DOSE A
Date: ____________________________
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Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947878
COLLECTED: 05-AUG-2015
08:49:32
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