Ask Dr. Z

Is this 93656 or 93653? "The patient presented to the EP lab in atrial flutter (CL 300ms). An ICE catheter was inserted via the left femoral vein to image the transeptal puncture. A 10 pole catheter was advanced into the CS. The activation of the atrial flutter was linear along the CS catheter (earliest at CS 5,6). Next the Lasso and ablation catheters were used to generate an activation map of the clinical atrial tachycardia. This was consistent with a left atrial roof dependent atrial flutter. After mapping, the Lasso was positioned in the large common left PV ostium - when the tachycardia changed in activation and CL (280ms) -- activation distal to proximal along CS. Linear ablation from 10 o'clock on the mitral annulus to the septal aspect of the RSPV was performed with initial slowing then termination of the atrial flutter #2. Short bursts of tachycardia was seen (similar activation pattern to AFL #1 - roof dependent). When ablation just posterior to the LSPV (area of slow conduction), salvos of AFL terminated.All PVs were confirmed to be isolated."