CV ASC Registry Education-ICD Pathway Condition History’s Child Fields

Video Transcription

Sequence 4400 Atrial Fibrillation Classification and Sequence 4405 Plans for Cardioversion of Atrial Fibrillation will populate when a history of atrial fibrillation is captured.  If a patient has been diagnosed with a history of atrial fibrillation, then more information is requested to depict its classification, but even more specifically, the most recent  classification. The Data Dictionary provides guidelines and definitions to help determine the best selection based on the individual patient.  This should be documented by the implanting physician, as it is a clinician's responsibility and cannot be made by the abstractor.  When the documentation is not clear, then we would ask you to clarify. For your information and knowledge, we will go over the definitions.  Paroxysmal is defined as atrial fibrillation that terminates spontaneously or with intervention within 7 days of onset. Episodes may recur with variable frequency.  Persistent is defined as continuous atrial fibrillation that has sustained 7 days or more or with electrical or pharmacological termination.  Long-standing persistent is defined as continuous atrial fibrillation of more than 12 months duration.  And finally, permanent is a term used when the patient and the clinician make a joint decision to stop further attempts to restore and or maintain sinus rhythm.  Acceptance of atrial fibrillation represents a therapeutic attitude on the part of the patient and clinician rather than an inherent pathophysiological attribute of the atrial  fibrillation. Acceptance of AFib may change as symptoms, the efficacy of therapeutic interventions, and patient and clinician preferences evolve.  Additionally, if a patient has been diagnosed with a history of atrial fibrillation, then  the registry wants to know if there is a planned cardioversion for their atrial fibrillation.  For your knowledge, a cardioversion is a procedure that uses synchronized shocks or intravenous medications to convert the rhythm to a sinus rhythm.  The notes further assist the abstractor in certain scenarios. For instance, sites would code no for a history of a cardioversion.  But on the other hand, sites would code yes if the patient was in atrial fibrillation and cardioverted prior to the start of the generator implant procedure for this admission.  And sites would also code yes if the patient is scheduled for a cardioversion.

Video Summary

Sequence 4400 and 4405 in the transcript deal with documenting a patient's history of atrial fibrillation and plans for cardioversion. The Data Dictionary helps classify atrial fibrillation types - paroxysmal, persistent, long-standing persistent, and permanent. Acceptance of AFib varies based on symptoms and treatments. Cardioversion uses shocks or medications to convert rhythm. Documentation clarity is crucial, and sites should note cardioversion history accurately. Coding for scheduled or prior cardioversions guides data entry. Physicians must document recent classification, ensuring accurate patient information for treatments. The registry requests cardioversion plans to inform care decisions, emphasizing the importance of patient and clinician collaboration in managing atrial fibrillation.

Keywords

atrial fibrillation

cardioversion

Data Dictionary

classification

documentation clarity