93609 Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for primary procedure)

Name of the Procedure:

Intraventricular and/or Intra-atrial Mapping of Tachycardia Site(s) with Catheter Manipulation

Summary

Intraventricular and intra-atrial mapping is a specialized procedure where catheters are used to measure electrical activity within the heart's chambers. This helps locate the exact area causing abnormal heartbeat patterns or tachycardia, allowing for targeted treatment.

Purpose

The procedure is primarily performed to diagnose and treat abnormal heart rhythms (tachycardia) by pinpointing the precise location within the heart where these rhythms originate. The goal is to identify the site of abnormal electrical activity so that it can be treated to restore normal heart rhythm.

Indications

• Symptoms of tachycardia, such as palpitations, dizziness, or fainting
• Diagnosis of atrial or ventricular tachycardia not identifiable by non-invasive tests
• Planning for radiofrequency ablation or other interventions to treat abnormal heart rhythms

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Certain medications might need to be adjusted or discontinued before the procedure.
• Pre-procedure tests like an electrocardiogram (ECG), echocardiogram, or blood tests may be required.

Procedure Description

1. The patient is prepped and taken to a specialized lab where the procedure will occur.
2. Local anesthesia and sedation are administered to ensure comfort.
3. A catheter is inserted through a vein in the groin or neck and guided into the heart using fluoroscopy (X-ray imaging).
4. The catheter records electrical activity from multiple sites within the heart chambers.
5. Adjustments and manipulations help pinpoint the origin of the abnormal rhythms.
6. If needed, an ablation or other therapeutic procedure may follow.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity of the tachycardia and the findings during the mapping.

Setting

Typically performed in a hospital’s electrophysiology lab.

Personnel

• Cardiologist specializing in electrophysiology
• Nurses
• Radiology technicians
• Anesthesiologist or nurse anesthetist for sedation

Risks and Complications

• Bleeding or infection at the catheter insertion site
• Blood clots or embolism
• Cardiac perforation
• Arrhythmia or other heart rhythm disturbances
• Allergic reaction to contrast dye or medications

Benefits

• Accurate diagnosis of the origin of abnormal heart rhythms
• Facilitation of targeted treatment leading to potential elimination of tachycardia
• Improved quality of life and symptom relief

Recovery

• Patients usually rest and are monitored for a few hours post-procedure.
• Most can return home the same day or the following day, with instructions to avoid strenuous activity for a few days.
• Follow-up appointments may be scheduled to assess heart rhythm and overall health.

Alternatives

• Medication management of tachycardia
• Non-invasive tests like ECG or Holter monitoring
• Surgery if structural heart issues contribute to the arrhythmia

Patient Experience

Patients might feel numbness at the catheter insertion site and a fluttering sensation as the catheters move within the heart. Discomfort is minimized through sedation, and post-procedure, mild soreness at the catheter site can be expected. Pain relief and comfort measures will be provided as needed.