ECG Interpretation Report (Pediatric)

Patient: [Full name and MRN]

Age at ECG: [Age at time of ECG] (Use days for neonates/young infants, months for infants, years for children/adolescents. Include gestational age at birth for premature infants if clinically relevant.)

Sex: [Sex used for ECG reference norms]

Date/Time: [ECG acquisition date and time]

Location: [ECG acquisition location]

Indication: [Reason for ECG] (If not provided on requisition, state "Indication not provided." Do not infer from findings.)

Technical Quality

[Overall signal quality: adequate / limited / poor] [Artifacts and lead placement concerns if present] (If quality is adequate with no concerns, a single sentence is sufficient. If technical factors could explain findings such as axis anomalies or pseudo-infarct patterns, explicitly document this.)

Measurements

• Ventricular rate: [Rate in bpm] (Include atrial rate if different from ventricular rate.)
• PR interval: [Interval in ms] (If not measurable, state reason.)
• QRS duration: [Duration in ms]
• QT interval: [Interval in ms]
• QTc: [Interval in ms] via [Bazett / Fridericia / other method] (If automated value appears inconsistent with tracing, note manual verification.)
• Axes: P [degrees], QRS [degrees], T [degrees]
• Additional measurements: [R/S amplitudes, ST deviation at J point, or other measurements when relevant to interpretation] (Include only when supporting specific findings such as hypertrophy or ischemia assessment. Omit line if none.)

Interpretation

Rate and Rhythm

[Primary rhythm, regularity, and any ectopy] (State sinus vs ectopic atrial, junctional, etc. Note respiratory sinus arrhythmia if present. Describe ectopy frequency and pattern if present. Do not label SVT unless tachyarrhythmia is actually captured.)

Axis Assessment

[QRS axis category and age-appropriateness] (State normal, rightward, leftward, or superior axis. Include brief differential only when abnormal and clinically relevant.)

Intervals and Conduction

[PR interval, QRS conduction, pre-excitation findings] (Note AV block grade if present. Describe bundle branch block or IVCD pattern if present. Document delta wave and short PR if pre-excitation suspected. For rSr' in V1, specify whether QRS duration supports normal variant vs conduction abnormality.)

Chamber Findings

[Atrial enlargement and ventricular hypertrophy assessment] (Document RAE, LAE, RVH, LVH, or biventricular hypertrophy only when criteria are met. Use probabilistic language and note limited specificity of ECG criteria. Mildly elevated voltages within expected pediatric variation should be characterized as normal variant rather than borderline hypertrophy.)

Repolarization

[ST segment and T wave findings] (Describe ST elevation/depression with lead locations and morphology. Specify T-wave inversions by leads and whether age-appropriate. Note pathologic patterns such as diffuse ST elevation with PR depression, Brugada-like morphology, or prominent U waves if present.)

QT/QTc Assessment

[QTc interpretation: normal / borderline / prolonged / short] (Use pediatric thresholds. For borderline values, note need for repeat ECG, medication/electrolyte review, or cardiology follow-up. Do not diagnose long QT syndrome based on a single borderline value.)

Other Patterns

[Additional findings if present] (Include pathologic Q waves, low voltage, pacing findings, or dextrocardia pattern vs lead misplacement with reasoning. Omit subsection if none.)

Pediatric Normal Variants

(Include this section only when the tracing contains patterns commonly misread as abnormal in children. Omit entirely if ECG is unequivocally normal without pitfall patterns.)

• [Normal variant finding with age context, e.g., T-wave inversion V1–V3 consistent with juvenile repolarization pattern, rightward axis appropriate for age, rSr' in V1 with normal QRS duration]

Comparison

[No prior ECG available for comparison / Compared with ECG dated [date]: [summary of meaningful changes in rhythm, axis, intervals, or new findings]] (If differences could be due to lead placement or artifact, state this.)

Impression

[Normal ECG for age / Abnormal ECG]

[Prioritized diagnostic statements using standardized terminology, 1–5 statements as appropriate] (List highest clinical significance first. Specify location and nature of findings rather than using vague phrasing like "nonspecific changes.")

[Recommendations if applicable] (Include for abnormal findings that will drive clinical decisions: repeat ECG, medication/electrolyte review, echocardiography, cardiology follow-up, ambulatory monitoring. Frame as "consider" or "recommend clinical correlation." Omit if normal ECG with no follow-up needed.)

[Critical communication] (If a critical finding was communicated urgently, note recipient, date/time, and confirmation. Omit if no critical findings.)

Interpreting Clinician: [Name, credentials, specialty]