CPT® Code 93615

1. Indications

The esophageal recording of atrial electrogram, represented by CPT® Code 93615, is indicated for various clinical scenarios where detailed assessment of atrial electrical activity is necessary. The following conditions may warrant this procedure:

• Assessment of Atrial Arrhythmias This procedure is often performed to evaluate patients experiencing atrial arrhythmias, which may include atrial fibrillation or atrial flutter, to better understand the underlying electrical activity.
• Preoperative Evaluation It may be indicated as part of a preoperative assessment for patients who are being considered for electrophysiological procedures or other cardiac interventions.
• Monitoring Heart Rhythm The procedure is utilized for continuous monitoring of heart rhythm in patients with known or suspected cardiac conditions, providing critical data for treatment decisions.

2. Procedure

The procedure for esophageal recording of atrial electrogram involves several key steps, which are detailed below:

• Step 1: Preparation The patient is prepared for the procedure, which may include obtaining informed consent and ensuring that the patient is in a comfortable position. Monitoring equipment is set up to track vital signs throughout the procedure.
• Step 2: Insertion of the Esophageal Probe An esophageal probe, which is equipped with electrodes, is carefully inserted through the patient's mouth. The physician advances the probe into the esophagus, positioning it just behind the heart to ensure optimal recording of the atrial electrogram.
• Step 3: Recording Atrial Electrograms Once the probe is correctly positioned, the physician begins to obtain atrial ECG recordings. These recordings capture the electrical activity of the atria, providing valuable information regarding the heart's rhythm and function.
• Step 4: Optional Ventricular Electrogram Recording If necessary, the physician may also obtain ventricular ECG recordings during this procedure. This step is not mandatory but can provide additional insights into the heart's electrical activity.
• Step 5: Pacing Procedure (if applicable) If the physician determines that pacing is required, they will initiate the pacing procedure. This involves delivering electrical impulses to the heart to assess its response and gather further ECG recordings.
• Step 6: Analysis and Reporting After completing the recordings, the physician reviews the data obtained from both the atrial and ventricular electrograms, as well as any pacing results. A comprehensive written report is then generated, summarizing the findings and any recommendations for further management.

3. Post-Procedure

Post-procedure care for patients who have undergone esophageal recording of atrial electrogram includes monitoring for any immediate complications, such as discomfort or adverse reactions to the procedure. Patients are typically observed until they are stable, and vital signs are regularly checked. The physician will review the results of the esophageal ECG recordings and discuss the findings with the patient, including any potential next steps in their treatment plan. Follow-up appointments may be scheduled to further evaluate the patient's condition based on the results obtained from the procedure.