Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconn
CPT4 code
Name of the Procedure:
Interrogation Device Evaluation of Implantable Cardioverter-Defibrillator (ICD) System with Substernal Electrode
Summary
In this procedure, a healthcare professional evaluates the functionality of an implantable cardioverter-defibrillator (ICD) that has a substernal electrode. This involves connecting to the device, recording its data, and then disconnecting it. The information gathered is analyzed, reviewed, and reported by a physician or other qualified healthcare provider.
Purpose
Conditions Addressed:
- Sudden cardiac arrest
- Ventricular arrhythmias
- Heart failure ##### Goals:
- Ensure the ICD is working correctly
- Adjust settings for optimal performance
- Monitor the patient's heart rhythm and response to the ICD
Indications
Symptoms/Conditions:
- Patients with a known history of life-threatening arrhythmias
- Individuals who have received an ICD for prevention of sudden cardiac death ##### Patient Criteria:
- Must have an ICD with a substernal electrode
- Regular follow-up or troubleshooting of ICD functionality
Preparation
Instructions:
- Avoid caffeine and nicotine for 24 hours before the evaluation
- Do not apply lotions or oils on the chest area ##### Diagnostics:
- Pre-procedure ECG (if recommended by physician)
- Review of recent medical history and current medications
Procedure Description
- Connection: The healthcare professional connects to the ICD using a specialized programmer.
- Recording: The device’s data is recorded, including battery status, lead function, and stored heart rhythms.
- Analysis: The captured data is analyzed to assess the ICD's performance and any recorded heart events.
- Adjustment: Settings are adjusted if necessary.
- Disconnection: The programmer is safely disconnected from the device.
Tools/Equipment:
- ICD programmer
- ECG machine (optional)
- Substernal electrode connections
Anesthesia/Sedation:
- Typically, no anesthesia or sedation is required for this evaluation.
Duration
Approximately 30 to 60 minutes.
Setting
The procedure is usually performed in an outpatient clinic, hospital setting, or specialized cardiac center.
Personnel
- Cardiologist or electrophysiologist
- Cardiac technician or nurse
Risks and Complications
Common:
- Minor discomfort at the connection site ##### Rare:
- Infection at the electrode site
- Miscommunication or misfiring of the device (very rare)
Benefits
- Verification that the ICD is functioning properly
- Adjustment of ICD settings to optimize patient safety
- Early detection of potential device issues
Recovery
Post-Procedure Care:
- Resume normal activities immediately after the procedure
- Follow-up as advised by the healthcare provider
Recovery Time:
- Immediate with no specific restrictions
Alternatives
Treatment Options:
- External defibrillator
- Medication for arrhythmia management ##### Comparison:
- ICDs provide continuous monitoring and automatic intervention, while external options require manual use.
Patient Experience
During the Procedure:
- Mild discomfort during connection and disconnection ##### After the Procedure:
- Little to no pain or discomfort
- Routine activities can be continued
- Any discomfort can be managed with over-the-counter pain relief if necessary
Overall, the interrogation device evaluation is essential for maintaining the safety and effectiveness of an ICD, allowing for timely adjustments and ensuring optimal heart health for the patient.