ODFS IV Pace v1.

2 clinical set up form

ODFS Pace v1.2 setup Date

Patient name…………………………. Clinician sign……………………………….

DOB/PID…………………………… Print name…………………………………

Phone Number …………………………….. Designation…………………………………..

Parameter Setting
Walking Set up Serial Number…………………………

Current mA
Pulse width ……………………….%
R.Ramp ms
Comments
Extn. ms

F.Ramp ms

Time out ms

Delay ms

Waveform ASYM / SYM

Freq. Hz

Sounder SETUP / OFF / ALWAYS

Beeps ON / OFF

Timing ADAPTIVE / FIXED /

NTO

Lock OFF / 1s / 3s

Exe. (Exercise OFF / ON

enabled)
Exercise Set up R ………. On ………….
Off ………
Steps

No.Walks

Walk Time :

No. Exe

Exe.Time :

Software version
ODFS IV Pace v1.2 clinical set up form

ODFS Pace v1.2 setup Date

Patient name…………………………. Clinician sign……………………………….

DOB/PID…………………………… Print name…………………………………

(Attach label if available) Designation…………………………………..

Resting
Heart Rate
58
Time for 10m Heart Rate Increase in Walking PCI
heart rate speed
NS1 20.6 75 17 0.49 0.58
NS2 19.8 76 18 0.51 0.59
S1 17.7 74 16 0.56 0.47
NS3 19.7 76 18 0.51 0.59
% change +10% -20%
NS - S
% Change +11% -23%
NS start

Exercise

Comments

Follow up