Please forward this error screen to sharedip-13214820582. Aetna considers external loop recorders experimental and investigational for all other indications because their effectiveness for indications other than the ones listed above has not been established. For evaluation of members with suspected atrial fibrillation as a cause of cryoptogenic stroke who have had a this blinding absence of light pdf Holter monitor or 48 hour telemetry.
Aetna considers MCT experimental and investigational for other indications because its effectiveness for indications other than the ones listed above has not been established. Reveal Insertable Loop Recorder by Medtronic, Inc. Aetna considers implantable loop recorders experimental and investigational for all other indications because their effectiveness for indications other than the ones listed above has not been established. EPS is no longer considered a prerequisite to insertion of an implantable loop recorder. Aetna considers the following experimental and investigational because their clinical value has not been established. Requests for cardiac event monitoring that do not meet the above criteria and requests for repeat studies within 1 year of a previous study are subject to medical necessity review.
Background Cardiac event monitors are small portable devices worn by a patient during normal activity for up to 30 days. The patient can initiate EKG recording during a symptomatic period of arrhythmia. Cardiac event monitors have primarily been used to diagnose and evaluate cardiac arrhythmias. Two different types of cardiac event monitors are available.
This feature is especially useful for people who lose consciousness when arrhythmias occur. One type of post-symptom event monitor is worn on the wrist. When symptoms occur, the patient presses a button to trigger an EKG recording. Another type of post-symptom event monitor is a device that the patient carries within easy reach. When symptoms occur, the patient presses the electrodes on the device against their chest and presses a button to trigger the EKG recording. Cardiac event monitors have been developed with automatic trigger capabilities, which are designed to automatically trigger an EKG recording when certain arrhythmias occur.
Automated trigger cardiac event monitors are thought to be more sensitive, but less specific, than manually-triggered cardiac event monitors for significant cardiac arrhythmias. Cardiac event monitors may come with 24-hour remote monitoring. Usually, EKG results are transmitted over standard phone lines at the end of each day to an attended monitoring center, where a technician screens EKG results and notifies the patient’s physician of any significant abnormal results, based on predetermined notification criteria. Standard cardiac event monitors come with 5 to 10 mins of memory.
Mobile cardiovascular telemetry is similar to standard cardiac telemetry used in the hospital setting. The manufacturer states that an important advantage of MCOT is that it is capable of detecting asymptomatic events and transmitting them immediately, even when the patient is away from home, allowing timely intervention should a life-threatening arrhythmia may occur. There is reliable evidence that MCT is superior to patient-activated external loop recorders for diagnosing cardiac arrhythmias. There is also evidence to suggest that MCT is superior to auto-triggered external loop recorders for diagnosing symptoms thought to be due to a cardiac arrhythmia. MCT was not designed to evaluate auto-triggered loop recorders, as this type of recorder was not available at all study sites.
The investigators sought to overcome this bias by having all monitoring strips and diagnoses evaluated by another electrophysiologist that was blinded to assignment. A number of retrospective uncontrolled studies have been published that have described the experience with MCT. MCT for monitoring patients with atrial fibrillation before and after catheter ablation for atrial fibrillation. The authors concluded that MCT has potential utility for this use. Home Service utilizes Cardiac Telecom’s Heartlink II Monitor, which has automatic arrhythmia detection and extended memory.
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