Mobile Cardiac Telemetry

By Perplexed Latest Reply 2012-07-19 02:45:00 -0500
Started 2012-06-22 00:15:43 -0500

If it looks like a duck, quacks like a duck, waddles like a duck …

Its not a cardiac event monitor - it is a mobile cardiac telemetry monitor.

Say what? I've been ordered to stop the coumadin and the accolate and scripted what I was told would be a 21 day cardiac event monitor. Yeah, right!!

I was told we'd go w/the e-Cardio since I liked e-Cardio's ER920W Cardiac Event Monitor so much better than the CardioNet thing that I hated.

Yeah, right! What arrived today was e-Cardio's Heartrack Ecat. Its not even featured on their website yet! It must be because I am so "mouthy" my cardiologist's office likes to use me as a guinea pig for the new "toys" on the market! *wicked grin*

I was quite excited when it arrived - at least at first. Still the same nice small box, no suitcase like CardioNet's - but - a monitor AND a "communicator" similar to the CardioNet.

But it all looks so much more simple and certainly less intimidating than that CardioNet suitcase. Anyway - the warning signals started blaring in my head - I got burned by CardioNet since my secondary insurance considered it experimental and wouldn't pay my Medicare copay to the sum of some $150.

So I called e-Cardio and told them I wouldn't activate it until I talked to my insurance tomorrow and why. Hey, they were great about it and told me to call the Billing Department between 9 AM and 6 PM EST tomorrow. So I'll need to get the billing code they are using and then spend the rest of the day on hold w/my secondary insurance. *sigh*

How come I can never do anything the easy way??? *sigh*

My COPD has really been kicking my bottom this past 10 days and the last 5 the old left chest pain is back (its chest muscle, not heart) and I have been so whipped out and tired and not sleeping for beans. I'm not looking forward to the phone marathon tomorrow.

My last appointment w/my pulmonologist I couldn't do the entire PFT test for the first time and was told I will no longer have to do one, from now on just the spirometry. But today while talking to his NP I was told when I see him next month I'l have to do a "walk test" (I sure as heck hope NOT the full six minute walk test - I'll never make it!!!). I'll be doing it so they can determine if my 02 needs have changed and I need an increase.

Oh whoopee!

16 replies

Perplexed 2012-06-22 12:33:58 -0500 Report

*wicked grin* My cardiologist's office is the guilty party!!!! Yeah, right!

e-Cardio called back a couple of minutes ago. She was wrong (yeah, right) and apologized. They bill Medicare, then secondary for copay, if secondary refuses as experimental they appeal. If secondary still refuses as experimental the bill is mine to pay.

I told her I was told we would be ordering the e-Cardio we had last time. She said no, my cardiologist's office (shame on them) specifically ordered the Heartrak ECOT rather than the ER920W. I told her I was pretty sure they didn't even KNOW about the Heartrak ECOT so didn't believe that.

Then somewhere along the way she admitted that if the ER920W isn't specified they send the ECOT.

I mean our discussion was all civil and pleasant but we both got our point across. You just can NOT completely trust these DME providers any more - if you ever could.

So - you will have to specifically order the ER920W. I'm almost disappointed. I kind of would have liked totry the ECOT and compare it to the MCOT. Seriously, I don't care, they can bill me til the cows come home.

The basic difference between the ECOT and the ER920W is that the ECOT records continuously in real time whereas the ER920W is a loop recorder and only records a few seconds after the event and backs up and records the few seconds before the event and sends that recording on to e-Cardio. So I can see the value of the ECOT …

.. if you have a patient that is very high risk and you wnat to know immediatley that they are in trouble, rather than receiving a phone call 20 minutes or so after the event you might want to consider the HEARTRAK ECOT. IF we could be sure that I would cooperate and have one event just to prove or disprove the value of the newer technology … I'd say lets go w/the Heartrak. But considering that most likely "ain't" nuttin' gonna hoppen just like w/the CardioNet …

I don't care. I left it up to my cardiologist's office to decide whether to call in a new order for the ER920W or whether we wanna go w/this Heartrak.

Perplexed 2012-06-22 08:42:15 -0500 Report

I talked to e-Cardio right away at 9 AM. I explained the situation and that IF my secondary considered the HEARTRAK ECAT experimental and wouldn't pay my copay e-Cardio could bill me til the cows came home and I wouldn't pay it. I'm of an age where I don't need and don't even want credit any more so hey, what do I care if they send it to collections or not?

I was told that Medicare considered it an approved item and would pay for it, which I knew from previous experience, and that if Medicare approved secondary insurances had to approve it too. Yeah, right! Maybe at one time but NOT TODAY!

I was told that Medicare would pay 80% and that if my secondary didn't pay my copay e-Cardio would appeal and if my secondary still wouldn't pay e-Cardio would absorb the copay and not dun me for it. She even checked and told me what the copay would be. $140. I told her, yeah, CardioNet's copay was $147.

Pardon me but that isn't good enough unless they want to send it to me IN WRITING.

The lady said that she wanted to double-check to make sure she wasn't giving incorrect information and would call me back. So I asked for the billing code they use so I could check w/my secondary insurance myself while awaiting her call back.

Oh, she said, they won't pre-approve it as they consider it experimental. Ahhhh.

One advantage over the CardioNet mobile cardiac telemetry monitor is the weight. The HEARTRAK ECAT only uses one AA battery which makes it LOT lighter weight than the CardioNet MCOT. THAT is a plus!

And, of course, NOW I understand the difference between CardioNet's MCOT and e-Cardio's ER920W. Well, I understand that the e-Cardio ER920W cardiac event monitor is NOT the same thing as the CardioNet MCOT and e-Cardio HEARTRAK ECAT mobile cardiac telemetry monitors. Beyond that … these last two have 3 leads and the ER920W only has 2 leads. But it did the job just fine for me and caught the info we needed to detect my A fib, etc.

So - I await her return call and we shall see what we shall see.

Perplexed 2012-06-26 22:51:32 -0500 Report

Well, I never did claim to be the brightest candle on the cake. The good Lord looks after fools and my life sure has been proof of that.

I did something I seldom do any more. I bought one of those insty lottery tickets - and won $250. So w/that burning a hole in my pocket and my curiosity about comparing the two brands of telemetry monitors …

I'm now back on a 3rd 21 day event monitor. This one is from e-Cardio again. It is the ECAT (HEARTRAK ECAT). So far I like it much better than CardioNet's. The main thing is it is lighter weight!!! And the "communicator" is lighter weight as well. Plus doesn't require a charger stand. Still much less intimidating and shipped in a much smaller box rather than the "suitcase" that CadioNet's arrives in.

And, of course, my secondary considers this ECAT experimental as well and I will be responsible for my Medicare copay.

The copay for either is roughly $150.

For those w/Medicare AND a secondary insurance but limited means, the eCardio ER920W loop event monitor is still available, most all secondary insurances recognize it and will pay the copay - BUT - the ER920W must now be SPECIFICALLY ordered or the ECAT will be sent instead. (26 June 2012)

Perplexed 2012-06-26 22:59:38 -0500 Report

Neither the ECAT's Monitor nor the Communicator are difficult to clip to the waist band and yet they are very secure on the waistband - unlike CardioNet's MCOTs.

And the patient has access to a slight bit more information about what is going on when and if something is going on. On the Monitor a green light flashes all the while it is "monitoring", unless a red light blinks to indicate a low battery - or a blue light flashes to indicate the Monitor is communicating w/the Communicator - and if it flashes fast repeatedly it is actually sending to eCardio via the Communicator - or if the blue light flashes slowly it is just communicating the latest info to the Communicator. I caught it "communicating" both ways, slow and then fast, once, Monday evening or was it sometime during the night? I was up and down all Monday night about every 1 1/2 to 2 hours.

One thing I DO NOT LIKE is the Communicator charging w/in 10 feet of me at night when I'm in bed trying to sleep. That freaking bright green light , especially when it turns off and then turns back on is enough to keep anyone awake, much less someone sensitive to light and waking like I am. I solved the problem by tucking it in the night stand drawer and closing the drawer. Just putting a sock over it didn't reduce the light enough. That is one strong little green light let me tell you!

This evening I experienced some SOB and some constriction at the top of my throat near my jaw, really did feel like I was being gently throttled so I decided I'd report it as an event - just outta curiosity. Yeah, well … so I gave the button a quick press.

But - duh - only a quick press. Which I realized later was too quick as I read up on the monitor yet again. It didn't register diddley squat because I didn't hear a short beep. Nor did I hear two later short beeps. And the light on the monitor remained on the green monitoring light, not the blue communicating light. I just didn't press it long enough, you do have to press it until you hear the single beep. I did think to check ole reliable, the oximeter, and the heart rate was flexing but w/in 79 to 87 bpm. If I'm remembering correctly had I been using the oximeter in recording mode that would have been registered as a "pulse event". (NOT the same thing as "pulse pressure", i.e. the difference between systolic and diastolic pressures on a blood pressure check).

Perplexed 2012-07-13 18:37:12 -0500 Report

I had to return the ECAT and go back to the ER920W. Our cell reception in this area is just too … it sucks.

The ECAT would have recorded and held a full 30 days of recording but it could only report it to e-Cardio reliably if I drove two miles north of my house for it to send. The ECAT can't send manually via a landline, it must be by cell.

If I had a serious event during that time it would not have been able to be sent to e-Cardio in a timely manner.

The ECAT uses AT&T. The only cell we've had be reliable at our house is Verizon. While we've never had anyone try AT&T here that I'm aware of we do know that Alltell, Nextel and TracPhone can't be used effectively here.

The ER920W can send data to eCardio via landline if necessary. It will usually send via cell IF you have decent cellular coverage in your area.

I'm due to return the ER920W Tuesday when we will have finished the 21 days ordered. My cardiologist is willing to extend the coverage to 30 days if I want but since nothing is happening nor has happened since my 3rd day of Rythmol almost a year ago why bother?

HeartHawk 2012-07-13 23:29:27 -0500 Report


Cool technology even with the hiccups! It will be especially interesting see what the findings are. Do you know if Rythmol (propafenone) is available as a generic? Also, how is it working for you? Thanks so much for sharing!


Perplexed 2012-07-14 09:59:15 -0500 Report

To my knowledge Rythmol is not available in generic form yet. And w/my insurance I'm pretty sure they would make me very aware that it is!! I've had no unpleasant or undesirable side effects from the Rythmol and it apparently is very effective for me as to the best of my knowledge and now three 21 day event monitors I've not had even one event since the third day of starting it.

Of course, we have to keep in mind my A fib was evidently caught early and was still very mild when caught. (God looks after fools, I'm living proof!). For maybe 2 years or so I encountered very light "butterfly" flutterings lasting only 10-12 beats maybe 2-3 times a year.

Then in 2010 I encountered strong, erratic heartbeats that lasted maybe 10-15 minutes about once a month from March to June or July. The last one in July tho was a bit of a tough one: very severe SOB, definite severe chest pain, cold sweat and lasted maybe 4-5 hours. HR was 240 at one point according to my Nonin and was still 160 when loaded in ambulance. But it ended whilst in ER and I was put on coumadin and diltiazem when leaving ER. I experienced edema w/the dilltiazem so was switched to Toprol.

I was put on a 21 day event monitor and surprisingly experienced a critical and a severe event w/in the the first couple of days! Rythmol was added and to the best of my knowledge I have not had an event since the third day of Rythmol taken in August of 2010. I've had two 21 days event monitors since then w/no episodes whilst wearing them.

The form of Rythmol I take is Rythmol SR 225 mg capsules, 1 twice a day. If I remember correctly Rythmol is usually scripted in another form taken 4 x daily. I refuse any medication requiring more than 2 x a day dosing. Its just a waste because w/in just a couple of days I'm forgetting more than 2 doses anyway. I'm lucky to remember the two doses!

HeartHawk 2012-07-15 22:47:04 -0500 Report


Excellent! Yeah the sustained release form twice daily is the best bet in my humble, non-MD reasoning for exactly the reason you offer. My guess is that is why they came up with this formulation and dosing.


Perplexed 2012-07-15 23:20:08 -0500 Report

My suspicious mind figgers the pharmaceutical companies deliberately come up w/these 4 x a day meds and then before the patent runs out they manage to develop a sustained release form so they can get a new patent stretch outta that form.

Ach, I've become such a cynic! *sigh*

Perplexed 2012-07-17 01:31:33 -0500 Report

HeartHawk, thanks for following this thread w/me. Its been an interesting experience for me. I thought others might find some interest in it as well as I was under the impression that there were other A fibbers who don't experience their A fib on a daily basis and need to go the event monitor route at least once.

HeartHawk 2012-07-17 22:47:13 -0500 Report


What you see here is why it is critically important for us to follow this thread. The sad fact is many (most in fact) are shy about chiming in largely (I think) because they don't think their experience or input is important or similarly technical or they feel they are inable to adequately express themselves.

Sadly, they do not relaize how the great majority yearn for any first-hand info and don't really concern themselves with typos, repetition, or techical prowess. they WANT the small, innocuous and personal detail - the more repetiton the better because it reinforces the common experience.

When everyone overcomes their fears, when they post and reply regularly without care to spelling, repetition, or technical depth then this forum will have reached its full potential - and what a wonderful thing that will be!


Perplexed 2012-07-18 22:22:45 -0500 Report

When I get the time I will have to get around to posting about my coumadin experience(s). I'm not one of the "norms", I guess I was just lucky that my A fib was caught early before it started "cascading" so my experience is most likely rather "rare" for those who habituate any A fib support forum.

Lets face it, most of us who seek out and hang out in the various health support forums are those who are having difficulty w/their health problems whilst those who have mild cases or who get their health problem under reasonable control have little to no need or interest in continuing to follow the forums - at least not for any length of time.

HeartHawk 2012-07-19 02:45:00 -0500 Report


No doubt you are correct. But, then again, those are the experiences that are most instructionive - what might happen, what to expect, and possible courses of action! Forwarned is for-armed.