Procedure code: K60.7 CRTP K59.6 CRTD
Severe LVSD, EF
LBBB, QRSD
NYHA 3 HF
Primary prevention CRT-D
----------------------
Intravenous antibiotics were given pre-procedure.
I located the axillary vein with radiographic guidance and used it for venous access.
Active right atrial appendage and active single coil right ventricular apical leads placed with good parameters
OC135/CAS2/Terumo to CS. Venogram:
Quartet to lateral branch over Courier medium wire
Device placed in pre-pectoral pocket
The wound was closed with absorbable sutures subcutaneously and to the skin.
Set up DDD bpm
LV pre-excitation by
AVDs 150/200
Standard primary prevention ICD settings: Monitor 160, VT zone 187, 35 intervals, ATP x3 then shocks, VF zone 240 ATP then shocks
------------------------
To minimize risk of lead displacement the patient has been advised to minimise movement of the relevant arm for two days and to avoid raising the arm above the horizontal for 4 weeks.
A PA and lateral chest X-Ray is to be performed in 3-4 hours to exclude pneumothorax or lead displacement. Please call me on 26539/ bleep 6911 to check the result. If x-ray done out of hours please bleep cardiology registrar on 4205 to check the X-ray.
A pacing check was done on the table and does not need to be repeated
May not drive for at least one month. Follow up has been arranged in ICD clinic in 6-10 weeks
Suitable for nurse-led discharge
Secondary prevention CRT-D
CRT-pacemaker
I dissected down to the cephalic vein and used it for venous access.
Insertion of CRT-P or upgrade to CRT-P K60.7
Implantation of CRT-D or upgrade to CRT-D K59.6