External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis
CPT4 code
Name of the Procedure:
External Patient Activated and Auto-Activated Electrocardiographic (ECG) Rhythm Derived Event Recording with Symptom-Related Memory Loop with Remote Download Capability Up to 30 Days, 24-Hour Attended Monitoring; Transmission and Analysis
Summary
This procedure involves wearing a portable device that records heartbeat patterns whenever it detects abnormal rhythms or when the patient activates it due to symptoms. Data is sent remotely for analysis over a 30-day period with continuous monitoring and support.
Purpose
To detect, record, and analyze irregular heartbeats (arrhythmias) that may not occur during a short ECG in a doctor's office. It aims to provide a comprehensive understanding of heart health over an extended period.
Indications
- Patients experiencing unexplained fainting (syncope)
- Intermittent palpitations or rapid heartbeats
- Suspected cardiac arrhythmias
- Post-surgery or post-procedure monitoring of heart rhythm
- Unexplained strokes
Preparation
- Patients may need to bathe and avoid lotions or oils before sensor application
- Review and adjust medications if necessary, per doctor’s instructions
- Undergo initial ECG or other cardiac assessments
Procedure Description
- Device Application: Electrodes are attached to the skin at specific points on the chest.
- Wearable Setup: The portable recording device is connected to the electrodes.
- Activation: The device activates automatically upon detecting abnormal heart rhythms or manually by the patient when symptoms are felt.
- Recording: Data, including a memory loop of heart activity before and after each event, is recorded.
- Transmission: Recorded data is wirelessly transmitted for real-time analysis by healthcare professionals.
- Monitoring: The patient is monitored round-the-clock for 30 days, with attended response to critical alerts.
Duration
The patient wears the device continuously for up to 30 days.
Setting
Typically performed on an outpatient basis at a clinic or at home with initial setup done in a healthcare setting.
Personnel
- Cardiologist or Cardiac Technician
- Trained nurses for initial setup
- Remote monitoring team
Risks and Complications
- Skin irritation from electrodes
- Discomfort from wearing the device long-term
- Potential data transmission issues
- False alarms or missed episodes
Benefits
- Provides extensive and detailed recording of heart rhythm over time
- Early detection of potentially serious arrhythmias
- Real-time monitoring allows for immediate medical intervention if required
- Non-invasive and relatively easy for patients to manage
Recovery
- No significant recovery is required.
- Patients can maintain their regular activities with minimal restrictions.
- Follow-up appointments may be scheduled to review the recorded data.
Alternatives
- Short-term Holter monitor: Continuous recording for 24-48 hours but with limited duration.
- Event monitor: Similar but patient-activated, not auto-activated.
- Implantable loop recorder: Longer monitoring but requires a minor surgical procedure for device implantation.
Patient Experience
Patients might feel the electrodes and device on their skin but can move about freely. Some may find the constant wear uncomfortable but it is generally well-tolerated. Any discomfort is typically minor and outweighed by the comprehensive heart monitoring benefits.