EPDIR-0423 - Metric 26 | Device Based Therapy Guidelines and AUC-0423 - Metric 26

Video Transcription

Video Summary

In this video, the speaker discusses a case scenario regarding the evaluation of a patient with a dual-chamber implant. The patient is a 55-year-old male who was admitted for an EPS and possible dual-chamber implant after experiencing presyncopal episodes. The patient had a history of first-degree AV block and symptomatic beta-blocker-induced sinus bradycardia. During the EP study, monomorphic VT was elicited, leading to the implantation of a dual chamber device for secondary prevention. The video reviews whether this patient is included in metric 26, which measures the proportion of ICD patients that fulfill a specific guideline recommendation. It is determined that the patient does not meet the numerator for this metric, as syncope is required in addition to the clinically relevant ventricular arrhythmia induced. The video also discusses the appropriate use criteria (AUC) document and different metrics that evaluate the patient's scenario, including those specific to dual chamber implants and secondary prevention. The patient is deemed not classifiable for secondary prevention in the AUC document but is classified as appropriate for a dual-chamber ICD implant based on indication 169 in the AUC document. The video emphasizes the importance of reviewing AUC metrics as an opportunity to evaluate real-world practices that may differ from guideline recommendations. The video is from the EP Device Implant Registry's April 2023 case scenario.

Keywords

dual-chamber implant

patient evaluation

presyncopal episodes

monomorphic VT

appropriate use criteria (AUC)