Radiofrequency ablation for atrial fibrillation in association with other cardiac surgery

Summary

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on radiofrequency ablation for atrial fibrillation in association with other cardiac surgery.

Description

Atrial fibrillation is the irregular and rapid beating of the upper two chambers of the heart (the atria). It may be classified as paroxysmal, persistent or permanent. Patients with atrial fibrillation may be asymptomatic or they may have symptoms including palpitations, dizziness and breathlessness. They also have an increased risk of stroke as a result of blood clots forming in the left atrium and then embolising to the brain. Although atrial fibrillation may occur in the absence of other heart disease, it is particularly common in patients with mitral valve disease.

Radiofrequency ablation of the atria can be performed via a catheter introduced through a femoral vein but surgical radiofrequency ablation for atrial fibrillation is typically carried out in patients undergoing concomitant open-heart surgery, including mitral valve replacement or repair. Radiofrequency is used to create lines of ablation rather than the incisions created in the traditional Cox maze surgery.

OPCS4.6 Code(s):

One of the following OPCS-4 codes is selected depending on the area of ablation, codes are also dependent on whether the surgery is performed open or transluminally:

K57.1 Percutaneous transluminal ablation of atrioventricular node

K57.2 Percutaneous transluminal ablation of conducting system of heart NEC

K57.4 Percutaneous transluminal ablation of accessory pathway

K57.5 Percutaneous transluminal ablation of atrial wall NEC

K62.2 Percutaneous transluminal ablation of atrial wall for atrial flutter

K62.3 Percutaneous transluminal ablation of conducting system of heart for atrial flutter NEC

K52.1 Open ablation of atrioventricular node

K52.8 Other specified open operations on conducting system of heart

 

In addition to one of the codes listed above the OPCS-4 code Y11.4 is assigned:

Y11.4   Radiofrequency controlled thermal destruction of organ NOC

            Includes: Radiofrequency ablation of organ NOC 

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding}

Details

Contact details:

Links:

	IPG121 Radiofrequency ablation for atrial fibrillation in association with other cardiac surgery: guidance (web format)	11 February 2011
	IPG121 Radiofrequency ablation for atrial fibrillation in association with other cardiac surgery - guidance	25 May 2005
	IPG121 Radiofrequency ablation for atrial fibrillation in association with other cardiac surgery - information for people considering the procedure, and for the public	25 May 2005
	Interventional procedure consultation document - radiofrequency ablation for atrial fibrillation in association with other cardiac surgery	29 December 2004
	Overview of radiofrequency ablation for atrial fibrillation in association with other cardiac surgery	29 December 2004