0422 - Sequence # 14739 | His / Left Bundle Lead and Metric 31-0422 - Sequence # 14739

Video Transcription

The EP Device Implant Registry Case Scenario for April of 2022 will review Sequence 14-739, His Left Bundle Lead, and Metric 31.  A dual-chamber ICD was implanted in a 64-year-old female. The physician's post-procedure note states, a peel-away sheath was placed over one of  the short J-guide wires, through which a His catheter and 3830 lead was inserted in advance to the right ventricle septum, under fluoroscopy, where it was actively fixated.  His bundle area pacing was attempted. Unable to get true His pacing, the right atrial lead was implanted with satisfactory sensing and pacing characteristics obtained.  Both leads were sutured into place. In this scenario, the patient received a dual-chamber ICD, and there was no attempt to place an LV lead via the coronary sinus.  Our question is, how is Sequence 14-739, His Left Bundle Lead 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, the question, and possible answers prior to making your selection.  The answer is number two, successfully implanted. Although the His pacing was suboptimal, the lead remained implanted.  Our follow-up question number two, is this patient included in the numerator of metric number 31, proportion of defibrillator procedures with an unsuccessful attempt to place a His  Left Bundle Lead? Number one, no. Or number two, yes.  The answer is number one, no. Although the His pacing was suboptimal, the lead remained implanted.  In this scenario, the patient met the denominator criteria for metric 31, proportion of defibrillator  procedures with an unsuccessful attempt to place a His Left Bundle Lead with the final device type of ICD dual chamber and a His Bundle Lead attempted.  The patient will be included in the patient level drill down. The numerator criteria is not met with the appropriate coding of implant successful in  Sequence 14-739, His Left Bundle Lead. Metric 31 is a negative metric, meaning the goal is not to be included in the numerator.  Thank you for viewing the EP device implant registry case scenario for April of 2022.

Video Summary

The summary of the video is a case scenario review of Sequence 14-739, His Left Bundle Lead, and Metric 31 for the EP Device Implant Registry in April 2022. The video describes a 64-year-old female patient who received a dual-chamber ICD. The physician attempted His bundle area pacing but was unable to achieve true His pacing. The right atrial lead was successfully implanted with satisfactory sensing and pacing characteristics. The LV lead was not attempted to be placed. The patient's His Left Bundle Lead is coded as successfully implanted. The patient is not included in the numerator of metric number 31, which measures unsuccessful attempts to place a His Left Bundle Lead. Metric 31 is a negative metric.

Keywords

Sequence 14-739

His Left Bundle Lead

Metric 31

EP Device Implant Registry

dual-chamber ICD