Thank you for reviewing the afib ablation registry monthly case scenario for March 2022. For this case scenario, we will be focusing on registry inclusion criteria. Mr. Stark underwent an afib ablation using pulmonary vein isolation as the strategy. Towards the end of the procedure, it was noted that the patient developed phrenic nerve paralysis and the procedure was stopped. The patient's phrenic nerve function was reassessed the morning after the procedure and was found to have normal function. The day after, Mr. Stark was brought back for a second ablation procedure in which an aflutter rhythm was ablated. Based on the documentation during this episode of care, will the second ablation procedure during the episode of care be included in the registry? Number one, no, or number two, yes. Please take a moment to review the documentation and question to determine the best answer. And the answer is number one, no. Based on the registry submission population inclusion criteria, all percutaneous catheter-based approaches to ablation of atrial fibrillation will be included in the registry. Procedures included are afib ablation alone, afib ablation plus aflutter, VT, AT ablation during the same procedure, and afib ablation plus an LAA occlusion during the same procedure. Procedures not included are AV node ablation plus pacemaker for treatment of afib rate control and atrial flutter VT, AT ablations only. In order for the procedure to be included in the registry, an afib rhythm ablation must be performed during the procedure. In this case, the second procedure was only for an aflutter rhythm ablation and an afib rhythm was not ablated, therefore, it will not be included. And our bonus question, based on the documentation, will phrenic nerve damage be coded as an intra- or post-procedure event? Number one, yes, or number two, no. And the answer is number two, no. If the nerve damage was transient and it resolved within the episode of care, it will not be coded as an event. If indeed the patient suffered lasting damage that did not resolve within the episode of care, please code as an intra- or post-procedure event in sequence numbers 9105 and 9110. In this case, Mr. Stark's phrenic nerve damage resolved within the episode of care and no lasting damage was documented. Please refer to the Submission Population Inclusion Criteria document. The document is located under the Resources tab under Documents. Once in the Documents page, the Inclusion Criteria document can be found under User Guide Documents. Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for March of 2022.

AFib Ablation Registry

March 2022

registry inclusion criteria

phrenic nerve paralysis

aflutter rhythm