Question

The following documentation is from the health record of a 67-year-old male.

Procedure: Placement of a dual chamber implantable pacing cardioverter-defibrillator

Indications: Patient has moderate ischemic cardiomyopathy, prior, infarct and stent

Description of the Procedure: After informed consent was obtained, the patient was brought to the cardiac lab. Teh procedure was done under conscious sedation with fluoroscopic guidance. 1 percent Lidocaine was used to anesthetize the skin under the left clavicle, and a skin incision was made. A pocket was made for the ICD generator and leads, securing good hemostasis. The left subclavian vein was easily cannulated twice using a pediatric set. which was upsized to regular 037 wires, the position of which was checked under fluoro

Answer 1

The procedure documented is the implantation of an ICD under conscious sedation, using fluoroscopy for guidance, in a patient likely at risk for serious cardiac arrhythmias.

Step-by-step explanation:

The documentation describes a medical procedure to implant an ICD (Implantable Cardioverter Defibrillator).

The anterior approach was taken, starting by the skin under the left clavicle where the incision and subsequent pocket for the ICD generator were created. Fluoroscopy was used to guide and position the wires correctly. The left subclavian vein access was achieved using a pediatric set, which was upgraded to standard wires, presumably for the leads. This procedure is typical in patients with cardiac issues who may be at risk for arrhythmias or heart failure and calls for careful insertion and placement of the device to ensure proper function and to avoid complications.

The integration of the ICD involved conscious sedation, pain management with 1 percent Lidocaine, and the use of fluoroscopy for visual guidance, which is a standard of care for such cardiology procedures. It's also implied that thorough cardio monitoring was conducted, probably including an ECG (Electrocardiogram) and possibly other heart function tests such as a stress test or continuous ambulatory electrocardiographs.