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2ND TIME! Epicardial Hybrid Thoracoscopic Sinus Node Modification for IST

Date: Dec 5, 2023

Question:

Facility charges only. Performed by CT Surgeon and Cardio Interventionalist in EP Lab. Pericardium retracted, exposed right atrium SVC and IVC. Exposed the pulmonary veins and posterior SVC. SA node mapped by CIV in baseline and on isoproterenol. Area marked and SVC RF ablation line with 2 burns above SA node, series of burns along the crista terminalis of RA. 3 burns places across the IVC RA junction. Elevated heart rate on isoproterenol so further mapping and RF ablation- 34 burns on CTI. 2 more burns at SVC RA junction. Further mapping by CIV as well as endocardial ablation via femoral access with RF ablation catheter. Due to cross-clamping of the patient's pacemaker leads during the SVC lesions, we performed testing both before and after the case. All lead parameters including impedance, threshold and sensing we restable both before and after. The patient's device was programmed to DDDR, 60-125 beats per minute at the end of the case. I am thinking 33265, 93631, 93286, 93623 for the facility charges. Please help!! Thank you in advance, you're the best!

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