Ecganalysisreport 4pdf

ECG Analysis Report with Mean Comparator Change
Sponsor:
Protocol:
Account:
Transmittal Number:
Array BioPharma Inc.

CLGX818X2109
746874
12947858
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 1 / DAY 1 / PRE DOSE A
03-NOV-2015
17:37:39
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002
Interval Duration Measurements

Warren, Dominic
Good Tracing
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) :
175
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
QTc Fridericia's (ms) :
75
N/A
N/A
413
N/A
N/A
417
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
Evaluation Date/Time:
For Site Use Only.

Investigator Signature: __________________________________________________
Muhammad Iqbal
30-JUN-2016 11:30 ET
Date: ____________________________
Generated on: 30-JUN-2016 11:35:23

1818 Market Street
Philadelphia, PA 19103
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
Array BioPharma Inc. - CLGX818X2109
SITE:
5009
INVESTIGATOR: Chmielowski, Bartosz
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947858
COLLECTED: 03-NOV-2015
17:37:39
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12809823
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
RUNIN END OF TREATMENT
05-JAN-2016
10:13:04
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002

Crockett, Hayley
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
72
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
833
N/A
N/A
PR Interval (ms) :
185
N/A
N/A
79
N/A
N/A
423
N/A
N/A
449
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Muhammad Iqbal
27-JUN-2016 07:06 ET
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 2 END OF TREAMTENT / /
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
COLLECTED: 05-JAN-2016
10:13:04
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12809827
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
RUNIN END OF TREATMENT
31-MAR-2016
12:19:27
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Cross, Katherine
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
67
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
893
N/A
N/A
PR Interval (ms) :
209
N/A
N/A
97
N/A
N/A
398
N/A
N/A
413
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Abnormal
Evaluation By:
Muhammad Iqbal
27-JUN-2016 07:06 ET
Findings
Conduction:
First Degree AV Block
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
COLLECTED: 31-MAR-2016
12:19:27
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12809826
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
UNSCHEDULED 1.5 POSTDOSE
07-AUG-2015
09:55:01
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001

Cross, Katherine
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
65
Comparator
(3 of 3)
Mean
61
Change
4
RR Interval (ms) :
929
985
-56
PR Interval (ms) :
133
131
QRS Interval (ms) :

QT Interval (ms) :
79
84
-5
403
406
-3
413
408
Evaluation
Interpretation:
Abnormal
Evaluation By:
Muhammad Iqbal
27-JUN-2016 07:05 ET
Findings
Conduction:
Left Anterior Hemiblock
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
COLLECTED: 07-AUG-2015
09:55:01
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12809825
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
UNSCHEDULED 1.5 POSTDOSE
07-AUG-2015
09:43:16
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001

Opasanya, Adebola
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
62
Comparator
(3 of 3)
Mean
61
Change
1
RR Interval (ms) :
971
985
-14
PR Interval (ms) :
133
131
84
84
QT Interval (ms) :
403
406
-3
407
408
-1
QRS Interval (ms) :
Evaluation
Interpretation:
Abnormal
Evaluation By:
Muhammad Iqbal
27-JUN-2016 05:31 ET
Findings
Conduction:
Left Anterior Hemiblock
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
09:43:16
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707263
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
UNSCHEDULED PREDOSE
03-NOV-2015
16:52:57
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Buurma, Emily
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
76
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
785
N/A
N/A
PR Interval (ms) :
185
N/A
N/A
96
N/A
N/A
378
N/A
N/A
410
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
B Ashalatha
23-JUN-2016 20:59 ET
Findings
Ectopy:
Atrial Premature Complexes
Visit: / SCR / A
Date of Birth 10-May-1939
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009
DATE OF BIRTH: 05/10/1939

7 DIGIT SUBJECT NUMBER: 5009003
/ SCR / A
76 bpm
786 ms
177 ms
106 ms
375 ms
422 ms
406 ms
405 ms
67/64/52
16:52:57
SINUS RHYTHM WITH OCCASIONAL SUPRAVENTRICULAR PREMATURE COMPLEXES

INCOMPLETE RIGHT BUNDLE BRANCH BLOCK
BORDERLINE ECG
CAUTION:
WAVEFORM QUALITY AND SCALING MAY BE AFFECTED BY THE RECEIVING FAX MACHINE
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707257
Subject Information
5009
924 Westwood Blvd.
Suite 200
PART 1 CYCLE 1 / DAY 1 / 1.5 POST DOSE
07-AUG-2015
09:48:51
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
24-JAN-1948
5009001

Philips, Neil
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
62
Comparator
(3 of 3)
Mean
61
Change
1
RR Interval (ms) :
971
985
-14
PR Interval (ms) :
132
131
QRS Interval (ms) :

QT Interval (ms) :
85
84
413
406
417
408
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 13:35 ET
Remarks: The mean comparison information has been updated.
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P1C1 / 1 / PD
62 bpm
960 ms
119 ms
89 ms
408 ms
416 ms
413 ms
413 ms
78/-35/55
09:48:51
SINUS RHYTHM WITH SHORT PR INTERVAL

ABNORMAL LEFT AXIS DEVIATION
ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12809824
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
PART 1 CYCLE 1 / DAY 1 / PRE DOSE C
07-AUG-2015
08:27:48
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001

Buurma, Emily
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
60
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
997
N/A
N/A
PR Interval (ms) :
137
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
82
N/A
N/A
412
N/A
N/A
412
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Muhammad Iqbal
17-JUN-2016 15:25 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
08:27:48
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707269
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 1 / DAY 1 / PRE DOSE C
09-NOV-2015
11:46:03
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Buurma, Emily
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
82
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
728
N/A
N/A
PR Interval (ms) :
193
N/A
N/A
98
N/A
N/A
372
N/A
N/A
413
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Muhammad Iqbal
16-JUN-2016 09:43 ET
Visit: R1C1 / 1 / C
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

R1C1 / 1 / C
81 bpm
735 ms
187 ms
97 ms
376 ms
438 ms
416 ms
413 ms
71/44/48
11:46:03
SINUS RHYTHM
POSSIBLE LEFT ATRIAL ENLARGEMENT
RSR (QR) IN V1/V2 CONSISTENT WITH RIGHT VENTRICULAR CONDUCTION DELAY
MODERATE ST DEPRESSION
ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707265
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 1 / DAY 1 / PRE DOSE A
09-NOV-2015
11:36:04
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Shergill, Parveen
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
81
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
741
N/A
N/A
PR Interval (ms) :
178
N/A
N/A
87
N/A
N/A
366
N/A
N/A
404
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Muhammad Iqbal
16-JUN-2016 09:43 ET
Visit: R1C1 / 1 / A
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

R1C1 / 1 / A
83 bpm
721 ms
170 ms
109 ms
379 ms
446 ms
422 ms
418 ms
54/46/50
11:36:04
SINUS RHYTHM
BORDERLINE ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707267
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 1 / DAY 1 / PRE DOSE B
09-NOV-2015
11:41:03
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Shergill, Parveen
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
81
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
737
N/A
N/A
PR Interval (ms) :
176
N/A
N/A
89
N/A
N/A
365
N/A
N/A
404
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Muhammad Iqbal
16-JUN-2016 09:43 ET
Visit: R1C1 / 1 / B
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

R1C1 / 1 / B
82 bpm
729 ms
176 ms
94 ms
374 ms
438 ms
415 ms
412 ms
48/46/53
11:41:03
SINUS RHYTHM
BORDERLINE ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2
ECG Analysis Report with Mean Comparator Change - (Revised, 16-Jun-2016)

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707767
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
PART 1 END OF TREATMENT
12-MAY-2016
11:41:45
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
57
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
1044
N/A
N/A
PR Interval (ms) :
137
N/A
N/A
82
N/A
N/A
387
N/A
N/A
382
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:14 ET
Findings
Ectopy:
Ventricular Premature Complexes
Remarks: The following demography or visit name was modified from the previous report:
Visit: RUNIN END OF TREATMENT / /
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

REOT /
61 bpm
981 ms
130 ms
91 ms
388 ms
391 ms
390 ms
390 ms
73/-12/50
COLLECTED: 12-MAY-2016
11:41:45
SINUS RHYTHM WITH OCCASIONAL ECTOPIC PREMATURE COMPLEXES

NORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707741
Subject Information
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 1 / DAY 21 / LEE011 4 POST
DOSE
27-APR-2016
15:43:18
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: V5
Heart Rate (bpm) :
Mean
82
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
81
Change
1
733
738
-5
179
183
-4
82
97
-15
QT Interval (ms) :
384
369
15
426
409
17
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Svetlana Nikitina
15-JUN-2016 14:22 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C1 / 21 / 4PD
80 bpm
743 ms
196 ms
87 ms
376 ms
436 ms
415 ms
412 ms
56/67/66
COLLECTED: 27-APR-2016
15:43:18
SINUS RHYTHM
SEPTAL INFARCT, AGE UNDETERMINED
MINIMAL ST DEPRESSION
ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707552
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 2 / DAY 1 / PRE DOSE
02-FEB-2016
08:49:27
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
66
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
906
N/A
N/A
PR Interval (ms) :
172
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
85
N/A
N/A
416
N/A
N/A
428
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Svetlana Nikitina
15-JUN-2016 14:22 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C2 / 1 / P
65 bpm
917 ms
165 ms
89 ms
418 ms
436 ms
430 ms
429 ms
55/55/43
COLLECTED: 02-FEB-2016
08:49:27
SINUS RHYTHM
NORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707787
Subject Information
5009
924 Westwood Blvd.
Suite 200
16-MAY-2016
12:00:39
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
83
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
725
N/A
N/A
PR Interval (ms) :
184
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
94
N/A
N/A
374
N/A
N/A
417
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Svetlana Nikitina
15-JUN-2016 14:22 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C2 / 15 / PD
82 bpm
725 ms
190 ms
93 ms
377 ms
442 ms
419 ms
416 ms
64/47/61
12:00:39
SINUS RHYTHM
ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707408
Subject Information
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 3 / DAY 15 / 1.5 POST DOSE
04-JAN-2016
16:44:55
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
71
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
842
N/A
N/A
PR Interval (ms) :
211
N/A
N/A
93
N/A
N/A
415
N/A
N/A
439
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Abnormal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:22 ET
Findings
Conduction:
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

RC3 / 15 / PD
71 bpm
840 ms
213 ms
94 ms
419 ms
457 ms
444 ms
441 ms
43/44/52
COLLECTED: 04-JAN-2016
16:44:55
SINUS RHYTHM WITH FIRST DEGREE AV BLOCK

ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707800
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
PART 2 END OF TREAMTENT
25-MAY-2016
14:07:24
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
76
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
789
N/A
N/A
PR Interval (ms) :
192
N/A
N/A
86
N/A
N/A
390
N/A
N/A
422
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:14 ET
Findings
Ectopy:
Atrial Premature Complexes
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2EOT /
76 bpm
781 ms
208 ms
92 ms
378 ms
427 ms
410 ms
409 ms
47/55/58
14:07:24
SINUS RHYTHM WITH OCCASIONAL SUPRAVENTRICULAR PREMATURE COMPLEXES

SEPTAL INFARCT, AGE UNDETERMINED
ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707709
Subject Information
5009
924 Westwood Blvd.
Suite 200
06-APR-2016
13:48:00
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
86
Comparator
(3 of 3)
Mean
81
Change
5
RR Interval (ms) :
701
738
-37
PR Interval (ms) :
178
183
-5
QRS Interval (ms) :

QT Interval (ms) :
93
97
-4
370
369
417
409
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Svetlana Nikitina
15-JUN-2016 14:09 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C1 / 1 / PD
85 bpm
705 ms
195 ms
92 ms
367 ms
437 ms
412 ms
409 ms
37/45/63
COLLECTED: 06-APR-2016
13:48:00
SINUS RHYTHM
NORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707604
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 5 / DAY 15 / PRE DOSE
17-FEB-2016
14:14:38
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
71
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
843
N/A
N/A
PR Interval (ms) :
190
N/A
N/A
QRS Interval (ms) :
103
N/A
N/A
QT Interval (ms) :
404
N/A
N/A
427
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Svetlana Nikitina
15-JUN-2016 14:07 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

RC5 / 15 / P
72 bpm
833 ms
192 ms
105 ms
401 ms
439 ms
426 ms
424 ms
20/44/60
COLLECTED: 17-FEB-2016
14:14:38
SINUS RHYTHM
BORDERLINE ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707383
Subject Information
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 2 / DAY 21 / 1.5 POST DOSE
22-DEC-2015
10:40:06
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
70
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
853
N/A
N/A
PR Interval (ms) :
208
N/A
N/A
QRS Interval (ms) :
101
N/A
N/A
QT Interval (ms) :
404
N/A
N/A
426
N/A
N/A
Evaluation
Interpretation:
Abnormal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:07 ET
Findings
Conduction:
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

RC2 / 21 / PD
70 bpm
850 ms
214 ms
92 ms
394 ms
427 ms
415 ms
415 ms
43/41/56
COLLECTED: 22-DEC-2015
10:40:06
SINUS RHYTHM WITH FIRST DEGREE AV BLOCK

ABNORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Ecganalysisreport 4pdf

Transféré par

Informations du document

Description originale:

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Ecganalysisreport 4pdf

Transféré par

Droits d'auteur :

Formats disponibles

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

For Site Use Only.

Generated on: 30-JUN-2016 11:35:23

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 30-JUN-2016 11:35:23

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

For Site Use Only.

Generated on: 27-JUN-2016 07:11:41

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 27-JUN-2016 07:11:41

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

First Degree AV Block

For Site Use Only.

Generated on: 27-JUN-2016 07:11:17

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 27-JUN-2016 07:11:17

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

Left Anterior Hemiblock

For Site Use Only.

Generated on: 27-JUN-2016 07:10:59

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 27-JUN-2016 07:10:59

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QTc Fridericia's (ms) :

QRS Interval (ms) :

Left Anterior Hemiblock

For Site Use Only.

Generated on: 27-JUN-2016 05:37:04

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 27-JUN-2016 05:37:04

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

Atrial Premature Complexes

For Site Use Only.

Generated on: 23-JUN-2016 21:05:12

Array BioPharma Inc. - CLGX818X2109

DATE OF BIRTH: 05/10/1939

SINUS RHYTHM WITH OCCASIONAL SUPRAVENTRICULAR PREMATURE COMPLEXES

Generated on: 23-JUN-2016 21:05:12

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.