The EP device implant registry case scenario for February of 2022 will review CSLV lead, sequence 7630 and metric 10, the proportion of defibrillator lab visits with an unsuccessful attempt to place the coronary sinus left ventricular lead. A 57-year-old male is admitted for a CRTD implant as his heart failure is not improving with maximum guideline-directed medical therapy. The RA and RV leads are successfully implanted. The LV lead was implanted via the coronary sinus into the lateral branch of the coronary sinus. However, the thresholds were inadequate and the lead was removed. Further attempts to implant an LV lead via the coronary sinus were abandoned. A left bundle lead was implanted. Our question is, how is CSLV lead, sequence number 7630 coded? Number one, not attempted. Number two, successfully implanted. Number three, previously implanted. Or number four, implant unsuccessful. Please take a few moments to review the documentation and the question before making your selection. The answer is number four. The clinician removed the LV lead after determining the thresholds were inadequate. Therefore, the implant is coded as implant unsuccessful. A successfully implanted left bundle lead is not captured in sequence number 7630, CSLV lead, even though it will allow for the pacing of the LV. Any attempt to implant the LV lead via the coronary sinus will be captured, even if the clinician successfully implants a left bundle lead. All attempts are captured to provide robust and accurate reporting. Let's look at metric number 10 in the Executive Summary Measures and Metrics Companion Guide version 2.3. The numerator includes all patients with implant unsuccessful coded in sequence number 7630. The denominator includes all patients with sequence 7620, device implanted coded yes, and successfully implanted or implant unsuccessfully coded in sequence 7630, CVLV lead. This measure assesses the hospital's rate of failure to successfully place a left ventricular lead via the coronary sinus. This unadjusted outcome metric is intended to be used for quality improvement at the hospital, provider, and or organizational level. It is not punitive, used for public reporting, or pay for service. The implanted left bundle lead is coded as successfully implanted in sequence number 14739, which is evaluated in metric 31, proportion of defibrillator procedures with an unsuccessful attempt to place a his left bundle lead. Thank you for viewing the EP device implant registry case scenario for February 2022, which highlights CSLV lead, sequence 7630, and metric 10, the proportion of defibrillator lab visits with an unsuccessful attempt to place the coronary sinus left ventricular lead.

EP device implant registry

heart failure

CRTD implant

LV lead

left bundle lead