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0824 - HIS vs CS Lead Individual Evaluation
0824 - HIS vs CS Lead Individual Evaluation
0824 - HIS vs CS Lead Individual Evaluation
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Video Transcription
The August case scenario will review multiple measures and metrics related to the permanent pacemaker procedure. Please note there is a new Executive Summary Measures and Metrics Companion Guide available as part of user guide documents, and it includes a metric ID to metric key crosswalk on page 5. Metric 32, the proportion of pacemaker procedures with an unsuccessful attempt to place a HISS or left bundle lead, the new metric number is referred to as metric key 11991. And metric 44, permanent pacemaker with HISS LV leads after unsuccessful implant of CS LV leads is referred to in the new companion guide as metric key 15651. And metric 45, permanent pacemaker with CS LV leads after unsuccessful implant of HISS LV leads is referred to in the new companion guide as metric key 15652. A 79-year-old male presents for a scheduled dual chamber permanent pacemaker. The physician's post-procedure note states, the left axillary vein was cannulated by a modified Seldinger technique under ultrasound and fluoroscopic visualization with insertion of a short J-guide wire. An eight French peel-away sheath was placed over the short J-guide wire, through which a long HISS sheath was placed in the RV and positioned into the septum. His deflection was noted, and the lead was actively fixated. The lead was then dislodged, and it was repositioned in the septum. The pacing and sensing thresholds were tested and found still not to be acceptable. CS LV lead was placed with acceptable pacing and sensing. The patient was transferred to the recovery unit and discharged home once cleared by radiology after a chest X-ray. Question number one, how is sequence 14739 HIST left bundle lead coded? Number one, not attempted. Number two, successfully implanted. Number three, previously implanted. Or number four, implant unsuccessful. Please take a moment to review the documentation and select an answer from the available options. The answer is number four, implant successful. Our question number two, how is sequence 7630 coronary sinus left ventricular CS LV lead coded? One, not attempted. Two, successfully implanted. Three, previously implanted. Or four, implant unsuccessful. Please take a moment to review the documentation and select an answer from the available options. The answer is number two, despite HIST lead dislodgement during the procedure, the physician successfully implanted the CS lead. Question number three, would the case be part of the numerator of the proportion of pacemaker procedures with an unsuccessful attempt to place a HIST left bundle lead? Number one, no. Or number two, yes. Please take a moment to review the documentation and select an answer from the available options. The answer is number two, implant unsuccessful did occur, so the numerator is met. For question number four, would the case be part of the numerator of permanent pacemaker with HIST LV leads after the unsuccessful implant of CS LV leads? Number one, no. Or number two, yes. Please take a moment to review the documentation and select an answer from the available options. The answer is number one, no. HIST LV leads implant is unsuccessful for this procedure. For question five, would the case be part of the numerator of permanent pacemaker with CS LV leads after the unsuccessful implant of HIST LV leads? Number one, no. Or number two, yes. Please take a moment to review the documentation and select an answer from the available options. The answer is number two, the case is part of the numerator as a failed attempt of HIST lead followed by a successful CS lead placement. Thank you for viewing the EP device implant registries August 2024 case scenario.
Video Summary
The video reviews multiple measures and metrics related to permanent pacemaker procedures. It introduces a new Executive Summary Measures and Metrics Companion Guide that includes updates such as the metric ID to metric key crosswalk. The scenario involves a 79-year-old male undergoing a dual-chamber pacemaker implant. Despite an initial unsuccessful attempt to place a HISS lead, a CS LV lead was successfully implanted. The video answers a series of questions about coding and whether the case meets the numerators for specific metrics related to unsuccessful attempts and subsequent successful lead implants.
Keywords
EPDI Registry
fractured lead
defibrillation
subcutaneous ICD
generator change
permanent pacemaker procedures
metric keys
dual chamber pacemaker
HISS and CS LV leads
lead placement challenges
pacemaker procedures
Executive Summary Measures
metric ID crosswalk
dual-chamber pacemaker
coding metrics
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