0520 - Sequence # 9025 | Bradycardia Adverse Events-0520 - Sequence # 9025

Video Transcription

Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for May 2020. We will be discussing Sequence 9025, Bradycardia Adverse Event.  We have documentation of a successful AFib ablation procedure in which pulmonary vein isolation and cryoablation were used as the ablating strategies.  While the patient was in the recovery area, the femoral vein sheaths were pulled. While manual pressure was being applied, the patient had a vagal response.  The patient complained of lightheadedness, their heart rate decreased to 35, and blood pressure decreased to 95 over 50.  A fluid bolus of 250 mLs of normal saline was given without any response. An atropine bolus was then given.  The patient responded well to the atropine bolus with vital signs returning to normal limits. Our question is, based on the documentation, will this event be coded as a bradycardia  adverse event in Sequence 9025? Yes or No. Please review the documentation and question to determine the best answer. We will give you a few seconds to review.  The answer is number one, yes. This event will be coded as a bradycardia adverse event. Based on the updated coding instructions, this event will be coded to indicate if the  patient experienced symptomatic bradycardia, bradycardia requiring pacing, or bradycardia requiring medical therapy.  Symptomatic bradycardia can include periods of reduced, unstable, or abnormal blood pressure with near syncope or episodes of syncope.  Some additional information to keep in mind when discussing the coding of bradycardia adverse events.  A bradycardia adverse event will not be counted as a major adverse event in Metric 4 if it  is transient and did not require permanent pacing, and Sequence 9030, bradycardia requiring permanent pacemaker, is coded as no.  Based on the documentation, this bradycardia event will not be included as a major event in Metric 4 as it did not require permanent pacing.  Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for May 2020.

Video Summary

The video discusses a case scenario in which a patient experienced a bradycardia adverse event after an AFib ablation procedure. During recovery, the patient had a vagal response, resulting in lightheadedness, a heart rate decrease to 35, and a decrease in blood pressure. Despite a fluid bolus, the patient did not respond, but after an atropine bolus, the vital signs returned to normal. The event will be coded as a bradycardia adverse event based on updated coding instructions. However, it will not be counted as a major adverse event in Metric 4 since it was transient and did not require permanent pacing. No additional credits were mentioned in the transcript.

Keywords

bradycardia adverse event

AFib ablation procedure

vagal response

atropine bolus

coding instructions