Thank you for viewing this cath PCI registry case scenario. In this scenario, we will cover sequence number 9002, intra-post-procedure events occurred as it relates to capturing a cardiac arrest. A patient is admitted with STEMI, and on his way to the cath lab, he suffers a V-fib arrest with return of spontaneous circulation after one defibrillation. Once in the procedure room and receiving a stent to the proximal LED lesion, he suffers a V-fib arrest when the wire enters his left ventricle for an angiogram. This too is responsive to one defibrillation, and return of spontaneous circulation is achieved. Is this captured as a cardiac arrest in sequence 9002? Number one, no. Or number two, yes. Please take a few moments to review the documentation prior to making your final selection. The answer is number two, yes. Per the V-fib data dictionary supplement with pending data element updates, cardiac arrest is defined as an acute cardiac event documented by one of the following. Ventricular fibrillation or rapid ventricular tachycardia or bradycardia rhythms with hemodynamic compromise causing loss of consciousness, or pulseless rhythms, or asystole, requiring cardiopulmonary resuscitation, two or more chest compressions or open chest massage, emergency temporary pacing, pericardiocentesis, institution of ECMO, or defibrillation. And without these measures, death would have almost certainly resulted. As the patient experienced an acute cardiac event of ventricular fibrillation that required cardiopulmonary resuscitation, in this case defibrillation, between start of procedure and discharge, cardiac arrest would be captured as the definition and target value are met. So now that we have reviewed the definition in its entirety, let's test your knowledge with some practice questions. Okay, let's do it with a new scenario. If after the cath lab procedure starts, the patient experiences ventricular tachycardia that converts back to sinus rhythm after two synchronized shocks, otherwise known as cardioversion, is this captured as a cardiac arrest in sequence 9002? The answer is no. While the patient experienced an acute cardiac event of ventricular tachycardia and required cardioversion times two, there was no documentation supporting it was a rapid ventricular tachycardia, causing hemodynamic compromise and loss of consciousness to meet the definition. Therefore, cardiac arrest would not be captured in this scenario. So what if after the cath lab procedure completed, the patient experiences asystole? However, due to a new do not resuscitate status, no cardiopulmonary resuscitation efforts were made and the patient expired. Is this captured as cardiac arrest in sequence 9002? The answer is yes. We know, we know that was a little bit tricky, but hold the tomatoes. As per the V5 data dictionary supplement with pending data element updates, cardiac arrest is defined as an acute cardiac event documented by one of the following, ventricular fibrillation or rapid ventricular tachycardia or bradycardia rhythms with hemodynamic compromise causing loss of consciousness or pulseless rhythms or asystole requiring cardiopulmonary resuscitation. And without these measures, death would have almost certainly resulted. However, a note further clarifies that if an event occurs that meets the above definition of cardiac arrest, in this case, asystole, code yes, regardless of a resuscitation status of DNR, hospice or comfort care. Okay, no more trick questions, but this is our final test, your knowledge question. So what if after the cath lab procedure started, the patient experiences complete heart block with a thready pulse and shallow respirations, making them unresponsive requiring transvenous temporary pacing? Is this captured as a cardiac arrest event in sequence 9002? And the answer is yes. And again, we look at the V5 data dictionary supplement with pending data element updates. The patient experienced an acute cardiac event of bradycardia. In this case, complete heart block with documentation supporting it caused hemodynamic compromise. In this case, shallow respirations and a thready pulse and loss of consciousness requiring cardiopulmonary resuscitation, in this case, temporary pacing to meet the definition. Therefore, cardiac arrest would be captured. Thank you for viewing this cath PCI registry case scenario.

cardiac arrest

cardiac catheterization procedures

ventricular fibrillation

ventricular tachycardia

asystole