External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events
CPT4 code
Name of the Procedure:
External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis, and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events
Common Names: Mobile Cardiac Telemetry (MCT), Mobile Outpatient Cardiac Monitoring, Mobile ECG Monitoring
Summary
This procedure involves the use of a mobile device to continuously monitor the heart's electrical activity for over 24 hours. The device records electrocardiograms (ECGs), performs real-time data analysis, and stores the data, which can be retrieved and reviewed later. The device can also capture specific events triggered by the patient's symptoms or automatically identified irregular heartbeats.
Purpose
The purpose of this procedure is to diagnose and monitor cardiac arrhythmias or any abnormalities in the heart's rhythm that occur intermittently and might not be captured during a standard ECG performed at a doctor's office.
Indications
- Palpitations
- Unexplained fainting (syncope)
- Chest pain
- Atrial fibrillation
- Cardiac arrhythmias
- Recurrence of known arrhythmias
- Monitoring after cardiac events or procedures
Preparation
- Patients may need to avoid applying lotions or oils to their chest on the day the device is applied.
- Inform the healthcare provider of any skin sensitivities or allergies to adhesives.
- Continue taking medications unless otherwise advised by the physician.
Procedure Description
- Preparation and Setup: The healthcare provider will clean the skin on the chest where the electrodes will be placed.
- Electrode Placement: Electrodes are attached to the chest, connected to a small portable device worn on the waist or in a pocket.
- Monitoring Period: The device continuously records the heart's electrical activity and transmits data to a central monitoring center. Patients can press a button on the device to mark symptoms or events.
- Data Analysis: The data collected is analyzed in real time with sophisticated algorithms to detect any abnormalities. Events can be reviewed by a technician or physician.
- Removal: After the monitoring period, typically lasting more than 24 hours, the device and electrodes are removed.
Duration
The monitoring period typically lasts for more than 24 hours, and up to 30 days if necessary, depending on doctor's orders.
Setting
The procedure can be performed in an outpatient clinic, the doctor's office, or even at the patient's home, allowing normal daily activities to continue.
Personnel
- Cardiologist or internal medicine physician
- Trained nurse or technician for device setup
- Central monitoring staff (technicians, cardiac nurses)
Risks and Complications
- Minor skin irritation from electrodes
- Allergic reactions to adhesive
- Data transmission issues if outside network range
- Rare: False positives or negatives due to device malfunction
Benefits
- Continuous heart monitoring can capture infrequent or elusive arrhythmias.
- Early detection of cardiac events.
- Data-driven diagnosis and treatment plans.
- Provides peace of mind to the patient through ongoing monitoring.
Recovery
- Minimal recovery needed as it is non-invasive.
- Patients can resume normal activities immediately after device removal.
- Follow-up appointments might be scheduled to review results and determine further actions.
Alternatives
- Holter monitoring: Similar to MCT but generally used for a shorter duration (24-48 hours) and lacks real-time data analysis.
- Event monitors: Used for intermittent recording when patients feel symptoms.
- Traditional in-office ECGs: Limited duration and might miss intermittent arrhythmias.
- Implantable loop recorders: More invasive but allows long-term monitoring (up to 3 years).
Patient Experience
- Mostly comfortable, but patients might find wearing electrodes and carrying the device slightly cumbersome.
- Potential skin irritation under electrodes.
- Patients receive guidance on device use and symptom recording.
- Detailed instructions and support offered to ensure comfort and effective monitoring.