Ask Dr. Z

I'm new to EP coding and not sure how to code ablation of the left atrial roof line and partial left atrial posterior wall after redo PVI in this case. Any recommendation is greatly appreciated.

"After PVI was achieved for all veins with entrance and exit block, isup was then titrated and numerous PACs were noted from the posterior wall. A sinus rhythm scar map was created of the posterior wall showing dense patchy scar. A left atrial roofline was applied connecting the superior veins with bidirectional block achieved. Next an inferior posterior wall RF line was delivered from the bottom of the left inferior vein to the bottom of the right inferior vein. Further ablation was then applied to areas of the posterior wall. Despite targeting all early signals and reinforcing the radiofrequency ablation lines full isolation could not be achieved. Partial isolation was achieved of the right aspect of the posterior wall."