Abstract: Electrocardiography is one of the most widely used non-invasive techniques for cardiac evaluation in clinical practice. However, substantial variation exists in the format, diagnostic terminology, and structural hierarchy of electrocardiogram(ECG)reports across medical institutions at different levels in China. This phenomenon—often described as “different reports for the same ECG”—poses significant challenges for clinical diagnosis and treatment, medical education, and scientific research. To promote the standardization, normalization, and homogenization of electrocardiogram diagnostic reports in China, the Electrocardiography Branch of Shandong Medical Association orga-nized experts from relevant fields to develop this expert consensus. The consensus was formulated through a comprehensive review of domestic and international literature and guidelines, combined with clinical practice in China. It systema-tically addresses key considerations in electrocardiogram data acquisition, clarifies the basic structure and essential elements of ECG reports, and standardizes diagnostic terminology and hierarchical organization for normal and abnormal electrocardiograms. Particular emphasis is placed on diagnostic features specific to pediatric electrocardiograms. In addition, the consensus discusses the standardized application of artificial intelligence-assisted ECG interpretation and outlines potential working models for wearable device integration. The objective is to provide scientific and practical guidance for electrocardiogram report writing, thereby enhancing the clinical diagnostic value of electrocardiography.

Key words: Electrocardiogram, Standardized reporting, Diagnostic terminology, Normalization, Homogenization