At this point in data entry in the ACC data collection tool, each site identifies the pathway it needs to go down based on the procedures being performed during the episode of care. Episode of care is best described as time between arrival at your facility through discharge. Currently, our participating sites can capture four pathways, including diagnostic, coronary angiography only, or PCI, with or without coronary angiography, or implantable cardiac defibrillator, or permanent pacemaker. Before we get into the details of each pathway, we must first educate how our beta launch expects our participants to code this data element. If you notice, the coding instructions ask the site to indicate all procedures. Additionally, the data collection tool will allow for multiple selections. The reason for this is to accommodate newer cardiovascular procedures being performed in the outpatient setting, and to accommodate multiple procedures being performed during the same lab visit and or episode of care. However, constraints were applied internally as the expectation set during beta launch was that the registry is only going to focus on one procedure during the lab visit and episode of care. Simply said, this is currently functioning as a single select field. If multiple selections are chosen, an error will trigger, forcing the site to go back and identify the single procedure being performed. First up is the diagnostic coronary angiography only pathway. If a patient has a diagnostic coronary angiography only procedure, which is the passage of a catheter into the aortic root or other great vessel for the purpose of angiography of the native or bypass grafts as their only procedure during the episode of care, then this is the most appropriate selection. If the patient undergoes the placement of an angioplasty guidewire, balloon, or other device such as stent, atherectomy, brachytherapy, or thrombectomy catheter into a native or bypass graft for the purpose of mechanical coronary revascularization with or without coronary angiography during the episode of care, then PCI with or without coronary angiography is the most appropriate selection. If the patient undergoes the placement of a device that detects a life-threatening rapid heartbeat, and if it occurs, the device quickly sends an electrical shock to the heart in hopes to restore normal rhythm during the episode of care, then implantable cardiac defibrillator is the most appropriate selection. And lastly, if the patient undergoes the placement of an electronic device to monitor heart rate and rhythm and give the heart electrical stimulation when it does not beat normally during the episode of care, then permanent pacemaker is the most appropriate selection.

ACC data collection tool

cardiovascular procedures

coronary angiography

PCI

implantable cardiac defibrillator