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SVI Isolation after PVI

Date: Jun 28, 2021


Can I report 93655 for SVC isolation after PVI for Afib? "The LSPV, LIPV, RSPV, and RIPV were circumferentially encircled as a pair. Isuprel was initiated and titrated pu to 20 mcg/min with the Pentaray on the posterior wall. No pulmonary vein triggers were seen. There were some right atrial premature beats. These could be SVC in origin, decision was made to isolate the SVC. The sheaths were withdrawn into the right atrium and the Pentaray catheter was used to perform a geometric map of the SVC-RA junction. High-output pacing around this region demonstrated phrenic nerve capture along the posterolateral SVC-RA junction. Using the ablation catheter and avoiding areas of phrenic nerve capture radiofrequency ablation lesions were delivered while the Pentaray catheter was advanced into the SVC. Isolation of the SVC was successfully obtained."

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