Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)
CPT4 code
Name of the Procedure:
Electronic Analysis of Antitachycardia Pacemaker System
Common names include Pacemaker Interrogation, Pacemaker Testing, and Pacemaker Programming.
Summary
This procedure involves checking and adjusting an implanted pacemaker that controls abnormal heart rhythms. It includes recording the heart's electrical activity, programming the device, inducing and stopping fast heartbeats, and interpreting the results.
Purpose
The procedure addresses issues with abnormal heart rhythms (tachycardia) and ensures the implanted pacemaker is working correctly. The goal is to maintain a normal heart rhythm and prevent episodes of dangerously fast heart rate.
Indications
- Symptoms such as dizziness, palpitations, or fainting that suggest abnormal heart rhythms.
- Routine check-ups for patients with an implanted antitachycardia pacemaker.
- New or worsening symptoms in pacemaker recipients.
Preparation
- Patients may be asked to avoid caffeine and certain medications before the procedure.
- A standard electrocardiogram (ECG) and a pacemaker device check will be performed.
Procedure Description
- The patient is positioned comfortably, and patch electrodes are placed on the chest.
- The pacemaker is accessed via a handheld scanner and programmer.
- The device records the heart's activity.
- Specific adjustments are made to the pacemaker's settings.
- The healthcare team may induce and then terminate tachycardia to test the device.
- Results are reviewed and interpreted to ensure optimal device function.
Tools:
- Electrocardiographic equipment
- Pacemaker programmer and scanner
Anesthesia/Sedation:
- Generally not required, but mild sedation may be used for patient comfort.
Duration
Approximately 30 minutes to 1 hour.
Setting
Hospital, outpatient clinic, or specialized cardiac unit.
Personnel
- Cardiologist or a specialized cardiac electrophysiologist
- Cardiac nurse or technician
Risks and Complications
- Minor discomfort or pain during testing
- Rarely, infection at the site of the pacemaker
- Temporary abnormal heart rhythms
- Potential device malfunction requiring reprogramming
Benefits
- Ensures the pacemaker is functioning optimally
- Prevents episodes of fast heart rate
- Improves or maintains quality of life
Recovery
- Patients can typically resume normal activities shortly after.
- Minor soreness at the electrode sites.
- Follow-up appointments as recommended by the healthcare provider.
Alternatives
- Periodic ECGs without device adjustment.
- Medication adjustments alone.
- Surgical revision if the pacemaker is not functioning.
Pros and Cons:
- Alternatives might be less invasive but may not offer the same precision in managing tachycardia.
Patient Experience
- Mild discomfort from electrode placement
- Typically painless adjustments
- Care team will provide comfort measures for any discomfort or anxiety
- Resume routine activities soon after the procedure.
Pain Management:
- Over-the-counter pain relievers if needed for minor discomfort.