Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator
CPT4 code
Name of the Procedure:
Repair of Single Transvenous Electrode, Permanent Pacemaker or Implantable Defibrillator
Summary
This procedure is performed to fix a faulty or damaged electrode (lead) in a permanent pacemaker or implantable defibrillator. These devices help to control abnormal heart rhythms, and when an electrode malfunctions, it can affect the device's performance.
Purpose
The procedure addresses issues with the electrode in a pacemaker or defibrillator that help control irregular heartbeats. The goal is to restore the device's functionality to ensure it effectively manages the heart's rhythm.
Indications
- Malfunctioning or damaged pacemaker or defibrillator lead
- Symptoms of device failure such as dizziness, fainting, or irregular heartbeats
- Diagnostic imaging or tests indicating lead dysfunction
- Patients who are dependent on the device for heart rhythm management
Preparation
- Follow fasting instructions, typically no eating or drinking 6-12 hours before the procedure
- Adjust or pause certain medications as instructed by the healthcare provider
- Complete any required diagnostic tests, such as an electrocardiogram (ECG) or imaging studies
Procedure Description
- After arriving at the facility, the patient is prepped and taken to the procedure area.
- An intravenous (IV) line is placed to administer medications.
- Depending on the case, local anesthesia and sedation or general anesthesia may be used.
- The surgeon makes an incision near the device implantation site.
- The faulty electrode is identified and repaired or replaced.
- The new or repaired electrode is tested to ensure proper function.
- The incision is closed and bandaged.
Duration
Typically, the procedure takes 1 to 2 hours, but it may vary based on complexity.
Setting
The procedure is usually performed in a hospital or specialized cardiac surgical center.
Personnel
- Cardiac surgeon or electrophysiologist
- Nurses and surgical technicians
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Infection at the incision site
- Bleeding or bruising
- Blood vessel or heart damage
- Lead dislodgement
- Rarely, complications related to anesthesia
Benefits
- Restored functionality of the pacemaker or defibrillator
- Improved heart rhythm management
- Reduction in symptoms related to device failure
- Immediate improvement in heart rhythm control
Recovery
- Monitoring in a recovery area for several hours post-procedure
- Instructions for wound care and activity restrictions
- Follow-up appointments to check device function and healing
- Most patients can return to normal activities within a few days to a week
Alternatives
- Medication adjustments to manage heart rhythm
- Non-surgical lead repair techniques
- Considering a different type of heart rhythm device if repair is not feasible
Patient Experience
During the procedure, if local anesthesia and sedation are used, the patient may feel some pressure but shouldn’t feel pain. Post-procedure, there may be some discomfort or soreness at the incision site, which is managed with pain medication. Normal activities can typically be resumed within a few days, with restrictions advised by the healthcare provider.