PVI and Posterior Wall Isolation for Atrial Fibrillation
Ablation lesions were delivered using an irrigated-tip ablation catheter (Biosense Thermocool SmartTouch STSF D curve) in a wide antral approach with separate en-bloc isolation of the left and right pulmonary veins. Initially a gap was left on the left inferior posterior wall due to heating in the nearby esophagus. First pass isolation was achieved bilaterally but the left veins acutely reconnected with entrance at the gap that was left. Focal ablation was delivered in that area which achieved isolation. Bidirectional block (entrance and exit block) were confirmed with the Pentaray in each vein with high output pacing from multiple sites. Isolated firing was observed.
would this be considered +93657 OR simply part of the PVI?
thanks in advance
Ablation lesions were delivered using an irrigated-tip ablation catheter (Biosense Thermocool SmartTouch STSF D curve) in a wide antral approach with separate en-bloc isolation of the left and right pulmonary veins. Initially a gap was left on the left inferior posterior wall due to heating in the nearby esophagus. First pass isolation was achieved bilaterally but the left veins acutely reconnected with entrance at the gap that was left. Focal ablation was delivered in that area which achieved isolation. Bidirectional block (entrance and exit block) were confirmed with the Pentaray in each vein with high output pacing from multiple sites. Isolated firing was observed.
would this be considered +93657 OR simply part of the PVI?
thanks in advance