Implantation of patient-activated cardiac event recorder
CPT4 code
Name of the Procedure:
Implantation of Patient-Activated Cardiac Event Recorder
Common Name(s): Cardiac Event Recorder Implantation, Patient-Activated Event Monitor Installation
Summary
The implantation of a patient-activated cardiac event recorder involves embedding a small electronic device under the skin to continuously monitor and record the heart's electrical activity. Patients can activate the device to record during symptomatic events like palpitations, dizziness, or fainting spells.
Purpose
The procedure helps diagnose irregular heart rhythms (arrhythmias) that are not easily detected by standard EKGs due to their sporadic nature. The goal is to capture data that can assist in diagnosing and managing cardiac conditions more accurately.
Indications
- Symptoms such as unexplained palpitations, dizziness, or fainting.
- Suspected arrhythmias not identified by other monitoring methods.
- Monitoring the efficacy of ongoing arrhythmia treatment.
- Patients with a history of strokes without a known cause.
Preparation
- Patients may be advised to fast for a few hours before the procedure.
- Certain medications might need adjustment or temporary cessation.
- Pre-procedure EKG and blood tests may be required.
Procedure Description
- The patient is given local anesthesia at the implantation site.
- A small incision is made, typically near the left pectoral region.
- The device, about the size of a flash drive, is inserted under the skin.
- The incision is closed with sutures or surgical glue.
- The patient is shown how to use the device and activate recording during symptoms.
- The procedure usually includes a test activation to confirm proper device functionality.
Duration
The procedure typically takes 30 to 60 minutes.
Setting
The procedure is performed in an outpatient clinic or hospital setting.
Personnel
- Cardiologist or electrophysiologist
- Nursing staff
- Medical technician (to assist with equipment)
Risks and Complications
- Infection at the incision site
- Bleeding or bruising
- Pain or discomfort at the implantation site
- Device malfunction or displacement
- Allergic reaction to the anesthesia
Benefits
- Accurate detection of arrhythmias
- Improved diagnosis leading to tailored treatment plans
- Non-invasive way of monitoring cardiac events over an extended period
- Patients can record events as they experience symptoms
Recovery
- Patients can often go home the same day.
- Instructions on wound care and activity restrictions are provided.
- Avoid heavy lifting or strenuous activity for a few days.
- A follow-up appointment is scheduled after a week to ensure proper healing.
Alternatives
- Holter monitor: A portable device worn externally for 24-48 hours.
- Extended EKG monitoring: Devices worn for several days or weeks.
- Potentially less invasive but less comprehensive in terms of long-term monitoring.
Patient Experience
- Mild discomfort or pain at the implantation site; managed with over-the-counter pain relievers.
- Patients might feel anxious about the procedure but usually find it minimally invasive.
- Some initial difficulty in getting used to the device's presence under the skin.
- Confidence in being able to document symptomatic episodes for better diagnostic accuracy.