Ask Dr. Z

Can you please offer guidance on this case?

The Pulmonary Veins were engaged with the Octaray and the pre-op CT scan along with ICE registered images were all used to merge with the Biosense mapping data obtained from the Octaray. The initial map demonstrated activity in all 4 veins as well as significant area of fractionation in the mid posterior wall.

Exit and Entry block were created and demonstrated in all of the major Pulmonary Veins (PVs) after the completion of the wide area circumferential ablation lesion sets.

At this point, after having isolated the veins are continued to be repetitive salvos of a left atrial tachycardia which mapped to a fractionated areas on the posterior wall and for this reason we isolated the posterior wall with a standard box lesion set. We then demonstrated block in the posterior wall and saw no more salvos of left atrial ectopy.

Would this be 93656 and 93657 or 93655 for the box set?

Thank you!