CPT® Code 0414T

1. Indications

The procedure is indicated for patients with moderate to severe chronic heart failure who require the removal and replacement of a permanent cardiac contractility modulation (CCM) system pulse generator. This intervention is necessary when the existing pulse generator is malfunctioning, needs upgrading, or requires replacement due to other clinical considerations.

• Chronic Heart Failure Patients with moderate to severe chronic heart failure may benefit from the CCM system, which aims to improve cardiac contractility.

2. Procedure

The procedure for the removal and replacement of the pulse generator involves several key steps to ensure proper execution and patient safety.

• Step 1: Incision An incision is made in the skin to provide access to the existing CCM device. This incision is strategically placed to minimize tissue damage and facilitate the procedure.
• Step 2: Disconnection Once the pulse generator is exposed, the electrodes that connect the pulse generator to the heart are carefully disconnected. This step is crucial to ensure that the old device can be safely removed without causing damage to the electrodes.
• Step 3: Removal of the Old Pulse Generator The old pulse generator is then removed from the body. This step may involve careful manipulation to ensure that the surrounding tissues are not harmed during the extraction process.
• Step 4: Insertion of the New Pulse Generator A new pulse generator is inserted into the body. It is essential that this new device is properly positioned and secured to ensure optimal function.
• Step 5: Reconnection of Electrodes The previously placed electrodes are then reconnected to the new pulse generator. This step is vital for restoring the functionality of the CCM system and ensuring that it can effectively deliver the necessary electrical impulses to improve cardiac contractility.
• Step 6: Closure of the Incision Finally, the incision is closed with sutures. Proper closure is important for minimizing the risk of infection and promoting healing.

3. Post-Procedure

After the procedure, patients are typically monitored for any immediate complications related to the surgery. Post-procedure care may include pain management, wound care instructions, and follow-up appointments to assess the functionality of the new pulse generator. Patients should be advised on signs of infection or other complications that may arise at the incision site. Recovery time may vary based on individual patient factors, but close monitoring is essential to ensure a successful outcome.