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Successful partial reconnection of PV's

Date: Jan 24, 2023


Would this be coded 93656 vs. 93653 due to successful reconnection/re-isolation of PV's?

Presenting rhythm was atypical left atrial flutter that was LA roof dependent

The atrial flutter terminated with mechanical effect of the catheter in the LA roof (near the left PV). Repeated attempts to re-induce the atrial flutter were unsuccessful, so we decided to perform LA roof ablation with a line of ablation from the left common PV to the right superior PV along the roof. The target power was set at 40 Watts. The target flow was set at 30 mL/min. Chronic partial reconnection noted of the right superior & left common PV's - successfully re-isolated. Re-do pulmonary vein antral isolation (PVAI) was performed using RF ablation. Ablation was performed in atrial pacing. During ablation along the posterior wall and anywhere close to the esophagus power was limited to 30-35 watts. Esophageal temperature was monitored throughout ablation. Maximal esophageal temperature = 37.1 deg C. After RF ablation entrance and exit block were noted in all pulmonary veins

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