CPT® Code 0683T

1. Indications

The programming device evaluation for the implantable synchronized diaphragmatic stimulation (SDS) system is indicated for patients who require augmentation of cardiac function. This procedure is typically performed in cases where there is a need to enhance the heart's ability to fill and empty effectively, thereby improving overall blood flow. Specific indications may include patients with heart failure or other cardiac conditions that benefit from synchronized diaphragmatic stimulation.

• Heart Failure Patients with heart failure may require this evaluation to optimize the functioning of the SDS system, which aids in improving cardiac output.
• Cardiac Dysfunction Individuals with various forms of cardiac dysfunction may benefit from the adjustments made during the programming evaluation to enhance their cardiac function.

2. Procedure

The procedure for programming device evaluation involves several critical steps to ensure the optimal functioning of the implantable SDS system.

• Step 1: Patient Preparation The patient is prepared for the evaluation by connecting them to an electrocardiogram (ECG) monitor. This allows for continuous monitoring of the cardiac rhythm throughout the procedure.
• Step 2: Device Connection A connection is established between the SDS device and the programming software equipment. This connection is essential for accessing the device's programming data and making necessary adjustments.
• Step 3: Data Review The healthcare professional reviews the current programming of the SDS device. This includes assessing the SDS sensing function, leads, and battery status to ensure that the device is functioning correctly.
• Step 4: Parameter Assessment Key parameters such as generator voltage, lead impedance, and pulse width are measured and evaluated. This assessment is crucial for determining the effectiveness of the device in stimulating the diaphragm.
• Step 5: Iterative Adjustments Based on the evaluations, iterative adjustments are made to the device settings. These adjustments are aimed at optimizing the stimulation of the diaphragm in sync with the cardiac cycle.
• Step 6: Testing Adjusted Parameters After adjustments are made, the new parameters are tested to ensure they provide the desired effect on cardiac function. Any necessary reprogramming of the device is performed following careful evaluation.
• Step 7: Documentation and Follow-Up The physician or qualified healthcare professional documents the findings and adjustments in a written report. The patient is then given instructions regarding any required follow-up services to monitor the device's performance.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any immediate effects of the adjustments made to the SDS system. Patients are typically advised on the importance of follow-up appointments to ensure the device continues to function optimally. They may receive specific instructions regarding activity restrictions or signs and symptoms to watch for that could indicate a need for further evaluation. Continuous assessment of the device's performance is crucial for maintaining effective cardiac function and ensuring patient safety.