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	<typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
	<id assigningAuthorityName="h.elga" extension="2250_1212149283.481" root="1.1.2.3.127.4"/>
	<code code="11490-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
		displayName="Discharge letter - Implantable Device Cardiac Follow-up"/>
	<title>Discharge Letter - Implantable Device Cardiac Follow-up</title>
	<effectiveTime value="20080530140803"/>
	<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25" displayName="Normal"/>
	<languageCode code="de-AT"/>
	<setId extension="2250_1212149283.481" root="1.1.2.3.127.4"/>
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		<patientRole>
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			<id assigningAuthorityName="Sozialversicherungnummer" extension="3211020841"
				root="1.1.2.3.127.5"/>
			<addr>
				<streetAddressLine>Oxford Street 12</streetAddressLine>
				<postalCode>8010</postalCode>
				<city>Graz</city>
				<country>Austria</country>
			</addr>
			<patient>
				<name>
					<given>John Q.</given>
					<family>Public</family>
				</name>
				<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>
				<birthTime value="19410802"/>
			</patient>
		</patientRole>
	</recordTarget>
	<author>
		<time value="20080530140803"/>
		<assignedAuthor>
			<id assigningAuthorityName="h.elga" extension="DocID" root="1.1.2.3.127.4"/>

			<assignedPerson>
				<name>Dr. Cardiologist</name>

			</assignedPerson>
			<representedOrganization>

				<id root="1.1.2.3.127.4"/>
				<name>General University Hospital Graz</name>
				<addr>
					<streetName>Auenbruggerplatz</streetName>
					<houseNumber>15</houseNumber>
					<postalCode>8036</postalCode>
					<city>Graz</city>
				</addr>


			</representedOrganization>
		</assignedAuthor>
	</author>

	<custodian>
		<assignedCustodian>
			<representedCustodianOrganization>
				<id assigningAuthorityName="h.elga" root="1.1.2.3.127.4"/>
				<name>Cardiology ward</name>
				<telecom value="tel:+43-316-385.2544"/>
				<addr>
					<streetName>Auenbruggerplatz</streetName>
					<houseNumber>15</houseNumber>
					<postalCode>8036</postalCode>
					<city>Graz</city>
				</addr>
			</representedCustodianOrganization>
		</assignedCustodian>
	</custodian>
	<legalAuthenticator>
		<time value="20080530140803"/>
		<signatureCode code="S"/>
		<assignedEntity>
			<id assigningAuthorityName="h.elga" root="1.1.2.3.127.4"/>
			<assignedPerson>
				<name>Dr. Cardiologist</name>
			</assignedPerson>
			<representedOrganization>
				<name>General University Hospital Graz</name>
				<telecom value="tel:+43-316-385.2544"/>
				<telecom value="fax:+43-316-385.3733"/>
				<addr>
					<streetName>Auenbruggerplatz</streetName>
					<houseNumber>15</houseNumber>
					<postalCode>8036</postalCode>
					<city>Graz</city>
				</addr>
			</representedOrganization>
		</assignedEntity>
	</legalAuthenticator>
	<componentOf>
		<encompassingEncounter>
			<code code="AMB" codeSystem="2.16.840.1.113883.5.4"/>
			<effectiveTime>
				<low value="20080530140803"/>
				<high value="20080530140803"/>
			</effectiveTime>
			<location>
				<healthCareFacility>
					<serviceProviderOrganization>
						<name>General University Hospital Graz</name>
						<addr>
							<streetName>Auenbruggerplatz</streetName>
							<houseNumber>15</houseNumber>
							<postalCode>8036</postalCode>
							<city>Graz</city>
						</addr>
					</serviceProviderOrganization>
				</healthCareFacility>
			</location>
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	<component>
		<structuredBody>
			<component>
				<section>
					<code code="10164-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
						displayName="Anamnesis"/>
					<title>Anamnesis</title>
					<text>The pacemaker (Biotronik, Philos II DR) was implanted on the 19th of May
						2008. The patient is free of complaints. The cicatrice does not show any
						hematoma. The blood pressure was 120/80 mmHg.</text>
				</section>
			</component>
			<component>
				<section>
					<code code="12223-410210-3" codeSystem="2.16.840.1.113883.6.1"
						codeSystemName="LOINC" displayName="General physical findings"/>
					<title>General physical findings</title>
					<text>The pacemaker works correctly.</text>
				</section>
			</component>
			<component>
				<section>
					<code code="8702-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
						displayName="Cardiophysiological parameters – programming parameters"/>
					<title>Cardiophysiological parameters – programming parameters</title>
					<text>
						<table>
							<tbody>
								<tr>
									<th>Paramter</th>
									<th>RA</th>
									<th/>
									<th>RV</th>
									<th/>
									<th>LV</th>
									<th/>
								</tr>
								<tr>
									<td>Threshold</td>
									<td>-</td>
									<td>V / - ms</td>
									<td>-</td>
									<td>V / - ms</td>
									<td>-</td>
									<td>V / - ms</td>
								</tr>
								<tr>
									<td>Impedance</td>
									<td>-</td>
									<td>kOhm</td>
									<td>-</td>
									<td>kOhm</td>
									<td>-</td>
									<td>kOhm</td>
								</tr>
								<tr>
									<td>Pulse amplitude</td>
									<td>3.6</td>
									<td>V</td>
									<td>5</td>
									<td>V</td>
									<td>-</td>
									<td>V</td>
								</tr>
								<tr>
									<td>Pulse width</td>
									<td>3.6</td>
									<td>ms</td>
									<td>5</td>
									<td>ms</td>
									<td>4</td>
									<td>ms</td>
								</tr>
							</tbody>
						</table>
					</text>

					<entry>
						<organizer classCode="BATTERY" moodCode="EVN">
							<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"/>
							<statusCode code="completed"/>
							<effectiveTime value="20080530140803"/>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_RA"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
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										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_RV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_LV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_PULSE_WIDTH_RA"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_PULSE_WIDTH_RV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_PULSE_WIDTH_LV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_IMPEDANCE_RA"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_IMPEDANCE_RV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_IMPEDANCE_LV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_AMPLITUDE_RA"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value unit="V" value="3.6" xsi:type="PQ"/>
									<interpretationCode code="H" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_AMPLITUDE_RV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value unit="V" value="5" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_PACE_THRESHOLD_AMPLITUDE_LV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value nullFlavor="NI" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_SET_PACING_PULSE_WIDTH_RA"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value unit="ms" value="3.6" xsi:type="PQ"/>
									<interpretationCode code="H" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_SET_PACING_PULSE_WIDTH_RV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value unit="ms" value="5" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>
							<component>
								<observation classCode="OBS" moodCode="EVN">
									<code code="IEEE1073.1.1.3" codeSystem="1.2.3.4.5.7.7"
										displayName="MDC_IDC_SYS_CHNL_SET_PACING_PULSE_WIDTH_LV"/>
									<statusCode code="completed"/>
									<effectiveTime value="20080530140803"/>
									<value unit="ms" value="4" xsi:type="PQ"/>
									<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"
									/>
								</observation>
							</component>		
						</organizer>
					</entry>


				</section>
			</component>
			<component>
				<section>
					<code code="8702-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
						displayName="Cardiophysiological parameters – programming parameters annotations"/>
					<title>Cardiophysiological parameters – programming parameters annotations</title>
					<text>
						<list>
							<item>Pulse amplitude ( RA ) is too high.</item>
						</list>
					</text>
				</section>
			</component>
			<component>
				<section>
					<code code="8702-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
						displayName="Cardiophysiological parameters – partly manually acquired data"/>
					<title>Cardiophysiological parameters – partly manually acquired data</title>
					<text>
						<table>
							<tbody>
								<tr>
									<th>Additional parameters</th>
									<th/>
								</tr>
								<tr>
									<td>Pacing rate</td>
									<td>75 bpm</td>
								</tr>
								<tr>
									<td>Battery voltage</td>
									<td>- V</td>
								</tr>
								<tr>
									<td>Expected lifetime</td>
									<td>24 months</td>
								</tr>
								<tr>
									<td>Magnet rate</td>
									<td>55 bpm</td>
								</tr>
								<tr>
									<td>Blood pressure</td>
									<td>120/80 mmHg</td>
								</tr>
								<tr>
									<td>Reprogramming</td>
									<td>not required</td>
								</tr>
								<tr>
									<td>Reprogrammed parameters</td>
									<td>-</td>
								</tr>
								<tr>
									<td>Correct sensing</td>
									<td>Yes</td>
								</tr>
								<tr>
									<td>Correct pacing</td>
									<td>Yes</td>
								</tr>
							</tbody>
						</table>
					</text>



				</section>
			</component>
			<component>
				<section>
					<code code="19009-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
					<title>Medication</title>
					<text>
						<table>
							<tbody>
								<tr>
									<th>Drug</th>
									<th>Dose morning</th>
									<th>Dose midday</th>
									<th>Dose evening</th>
								</tr>
								<tr>
									<td>LASIX - 40 mg</td>
									<td>1</td>
									<td>0</td>
									<td>0</td>
								</tr>
							</tbody>
						</table>
					</text>

					<entry>
						<substanceAdministration classCode="SBADM" moodCode="EVN">
							<text>Lasix 40mg 1x morning</text>
							<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true">
								<phase value="200805300800"/>
								<period value="1" unit="d"/>
							</effectiveTime>
							<doseQuantity>
								<center value="40" unit="mg"/>
							</doseQuantity>
							<consumable>
								<manufacturedProduct>
									<manufacturedLabeledDrug>
										<code code="12585" codeSystem="1.2.276.0.76.4.6"
											codeSystemName="Pharmazentralnummer"
											displayName="Lasix 40mg"/>
									</manufacturedLabeledDrug>
								</manufacturedProduct>
							</consumable>
						</substanceAdministration>
					</entry>


				</section>
			</component>
			<component>
				<section>
					<code code="46583-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
						displayName="Further therapy recommendation"/>
					<title>Further therapy recommendation</title>

					<text>
						<content ID="REF_DIAG">We recommend to continue the current therapy.</content>
					</text>

					<entry>
						<observation classCode="OBS" moodCode="EVN">
							<code code="DISDX" codeSystem="2.16.840.1.113883.6.1"
								codeSystemName="LOINC" displayName="diagnosis"/>
							<statusCode code="completed"/>
							<effectiveTime>
								<low value="20080530140803"/>
							</effectiveTime>
							<value xsi:type="CD" code="Z45.0" codeSystem="2.16.840.1.113883.6.90"
								codeSystemName="ICD-10-CM"
								displayName="Adjustment and management of cardiac pacemaker">
								<originalText>
									<reference value="#REF_DIAG"/>
								</originalText>
							</value>
						</observation>
					</entry>

				</section>
			</component>
			<component>
				<section>
					<code code="21979-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
						displayName="Next device follow-up"/>
					<title>Next device follow-up</title>
					<text>The next follow-up examination of the pacemaker at the University Hospital
						Graz is recommended in two months. An appoiuntment has been made for you on
						the 29th of July 2008 at 13:30. </text>
				</section>
			</component>
		</structuredBody>
	</component>
</ClinicalDocument>

