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/policies/clinical/uwhc-clinical/department-specific/heart-and-vascular-care-clinic/hvc-3.policy

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UWHC,

Policies,Clinical,UWHC Clinical,Department Specific,Heart and Vascular Care Clinic

Pacemaker Transtelephonic Check (HVC)

Pacemaker Transtelephonic Check (HVC) - Policies, Clinical, UWHC Clinical, Department Specific, Heart and Vascular Care Clinic

HVC

HVC Pacemaker Transtelephonic Check  
Category:  UWHC Departmental Policy   
Policy Number:  HVC    
Effective Date:  August 23, 2013   
Version:  Revision    
Manual:  Heart and Vascular Care Clinic    
Section:  Pacemaker Transtelephonic Check    
     
 
 
I. PURPOSE

The policy is to provide guidance to the Device Nurse, who is specially trained in Cardiovascular Implantable
Electronic Devices (CIED) and who is checking the pacemaker. This policy will provide optimal safety and security
for the patient with a pacemaker while maximizing the life and performance of the pacemaker.

II. POLICY

The Device Nurse will monitor for appropriate capture, sensing and magnet response.

III. PROCEDURE
A. Pull up patient information in Paceart, the charting system that supports CIED.
1. Click on follow-ups > Pacemaker TTMs > New event.
B. Phone patient at given number, this may be their home number or a number that was previously arranged
with patient.
C. An assessment is completed with the patient (any complaints of increase in shortness of breath or activity
in tolerance) which allows the Device Nurse to focus on/document any specific problems.
D. Have patient put on wrist bands and turn on monitor. Listen for tone to be steady, may hear clicking, but
no static.
1. If static is heard, have patient double check connections, apply water to inner wrist, make sure
patient isn’t sitting near computer, television or radio.
2. If no sound, have patient change battery in transmitter.
E. The first of three 30 second strip will be recorded.
1. Have patient place phone in transmitter cradle, per transmitter directions. After 40 seconds, the
patient may pick up the phone.
2. Monitor for appropriate capture and sensing.
3. After 30 seconds, click disk icon > Save > uncheck Print > disk icon > Save.
F. The second 30 second strip will be with magnet over the pacemaker.
1. Have patient place phone in transmitter cradle and then place the magnet, that is located in the
transmitter box, over their pacemaker. After 40 seconds, the patient may pick up the phone.
2. Monitor for appropriate magnet rate/elective replacement indicator rate specific for the device.
a. If elective replacement rate is noted, patient will be scheduled to see the
Electrophysiologist (EP) in clinic to discuss the procedure.
b. Document findings in patient’s electronic medical record.
c. If the rate isn’t at the appropriate magnet response or elective replacement rate
(specific rates are noted in Paceart, which is dependent on device company/model
number), have the patient reposition the magnet and record again.
3. After 30 seconds, click disk icon > Save > uncheck Print > disk icon > Save.
G. The last 30 second recording will be without the magnet.

1. Have the patient place phone in the transmitter cradle. After 40 seconds, the patient may pick
up the phone.
2. Monitor for appropriate capture and sensing.
3. After 30 seconds, click disk icon > Save > uncheck Print > disk icon > Save.
H. When the three recordings are completed, verify next appointment appropriate for age of the device (see
below).
I. Transfer interrogation to Paceart for charting.
1. Verify transferred information.
2. Fill in any added information and chart narrative specific to findings, changes and outcomes.
J. Print all needed copies of the Paceart report.
1. All copies will go to the EP Physician for reading and signing, before being sent to the
corresponding destination.
2. One each for hospital electronic medical records, entered into patient’s electronic medical record,
and Referring Physician(s) outside the UW Health systems.
K. Complete Remote Encounter in patient’s electronic medical record, file charges accordingly.
L. Routine follow up for patients with pacemakers:
1. Two week post implant.
2. Checks are done every 3 months with a combination of home transmissions and clinic checks.
3. When device reports 1 year to elective replacement, home transmissions will be done monthly.
4. More frequent checks if medically needed or battery status indicates.

IV. REFERENCES

Heart and Vascular Care Clinic – Implantable Cardioverter Defibrillator (ICD) Clinic Check, Routine
Heart and Vascular Care Clinic - Pacemaker Clinic, Routine Visits
Heart and Vascular Care Clinic - Remote Transmission of an Implantable Loop Recorder (ILR)
Heart and Vascular Care Clinic – Remote Transmission of a Pacemaker, Implantable Cardioverter Defibrillator
(ICD)

V. WRITTEN BY

Clinical Program Coordinator, Heart and Vascular Care Clinic

VI. REVIEWED AND APPROVED BY

Ambulatory Policy and Procedure Committee
Clinic Manager, Heart and Vascular Care Clinic
Clinics Administration
Dr. Michael Field, Assistant Professor, Director of Electrophysiology

SIGNED BY

Deborah D. Tinker, MSN RN CENP, Director, Ambulatory Nursing