33284 Removal of an implantable, patient-activated cardiac event recorder

Name of the Procedure:

Removal of an Implantable, Patient-Activated Cardiac Event Recorder

Summary

This procedure involves the surgical removal of a small device implanted under the skin that records heart activity. The device, known as a patient-activated cardiac event recorder or loop recorder, is often used to diagnose heart rhythm abnormalities.

Purpose

This procedure addresses issues like unexplained fainting spells, palpitations, unexplained strokes, or cardiac arrhythmias. The primary goal is to remove the device safely after it has provided sufficient diagnostic information.

Indications

• Unexplained fainting (syncope)
• Palpitations
• Cardiac arrhythmias
• Unexplained strokes The procedure is typically warranted once the device has recorded enough diagnostic data and is no longer needed.

Preparation

• No need for fasting.
• Continue taking prescribed medications unless otherwise directed.
• A pre-procedure check-up to assess general health, including blood tests and an ECG, may be required.

Procedure Description

1. The area where the device is implanted (usually the chest) is cleaned and sterilized.
2. Local anesthesia is administered to numb the area.
3. A small incision is made over the implantable device.
4. The device is gently removed from its pocket under the skin.
5. The incision is closed with sutures or adhesive strips and bandaged.

Tools and Equipment:

• Scalpel
• Sterile bandages and gloves
• Local anesthetic
• Sutures or adhesive strips

Duration

Typically, the procedure takes about 15-30 minutes.

Setting

The procedure is performed in an outpatient clinic or a hospital setting.

Personnel

• Cardiologist or surgeon
• Nurse
• Medical assistant

Risks and Complications

Common risks:

• Minor bleeding
• Infection at the incision site Rare risks:
• Damage to nearby structures
• Allergic reaction to the anesthetic Management includes antibiotics for infection and close monitoring post-procedure.

Benefits

The primary benefit is the removal of a device that has completed its diagnostic purpose. The patient can expect to have normal skin healing at the removal site, with minimal discomfort.

Recovery

• Keep the incision site clean and dry.
• Follow any provided wound care instructions.
• Avoid strenuous activity for several days.
• A follow-up appointment is usually scheduled to assess healing.

Alternatives

If the device needs to remain for ongoing diagnostics, the alternative is to delay removal. There are no other non-invasive alternatives once the diagnostic purpose of the implantable recorder is complete.

Patient Experience

Generally, patients experience minimal discomfort during and after the removal, thanks to local anesthesia. Post-procedure, there may be slight tenderness or swelling at the incision site, manageable with over-the-counter pain medication and proper wound care.