Cavotricuspid Isthmus Ablation Meaning, Procedure, ICD-10 & CPT Code

Cavotricuspid Isthmus Ablation Meaning

Cavotricuspid isthmus ablation is a procedure that is used to treat atrial flutter, a heart disease. It is a minimally invasive procedure carried out by electrophysiologists with the goal of reestablishing the healthy heart rhythm and treating atrial flutter symptoms. 

Atrial flutter is a type of abnormal heart rhythm. It happens when abnormal electrical signals move through the heart's upper chambers, or atrium. This causes rapid and coordinated contraction of the atria but slower transmission of electrical signals to the ventricles, the lower chambers of the heart.

Cavotricuspid Isthmus Ablation Procedure

Cavotricuspid isthmus ablation is a catheter-based technique that uses radiofrequency energy to make tiny scars or lesions in the cavotricuspid isthmus. The faulty electrical pathways that cause atrial flutter are disrupted by these scars. The major purpose of this technique is to eliminate or considerably minimize the occurrence of atrial flutter episodes.

Preparing for the Procedure Steps

Your electrophysiologist will thoroughly review your medical history and run a number of diagnostic tests before performing cavotricuspid isthmus ablation. A transesophageal echocardiography (TEE), an electrocardiogram (ECG), and an echocardiogram are some of the tests that may be performed. Your healthcare practitioner may urge you to stop using some medications before the treatment.

Cavotricuspid isthmus ablation is often conducted in a specialized cardiac catheterization laboratory. The general steps of the procedure are listed below:

Step 1: Anesthesia

The area where the catheter is inserted will be numbed by a local anesthetic. To keep you at ease throughout the surgery, conscious sedation or general anesthesia may occasionally be employed.

Step 2: Catheter Insertion

Your electrophysiologist will put a catheter—a small, flexible tube—into a blood vessel, typically in the arm or groin. Under X-ray guidance, the catheter is precisely positioned in the direction of the heart.

Step 3: Mapping and Ablation

When the catheter reaches the heart, it is placed in the cavotricuspid isthmus. In order to find the aberrant electrical signals causing atrial flutter, specialized mapping techniques are employed. The catheter is then used to administer radiofrequency radiation, which causes lesions to form in the desired location.

Step 4: Evaluation and Repeat Ablation

Your electrophysiologist will test for any remaining abnormal electrical impulses after the initial ablation to determine the treatment's success. Additional ablation may be required if the aberrant pathways are not completely eradicated.

Cavotricuspid Isthmus Ablation Recovery 

You will be observed for a few hours in a recovery area after the surgery. The area where the catheter was inserted usually bruises or causes slight discomfort. Your medical team will provide you advice on how to take care of yourself after the treatment, including any necessary medicines, physical activity limitations, and follow-up consultations.

Cavotricuspid Isthmus Ablation Success Rate

Atrial flutter is successfully treated with Cavotricuspid isthmus ablation. Many people see a considerable improvement in their symptoms or a full recovery. However, there could be hazards, just like with any medical procedure. These include bleeding, infections, blood vessel damage, irregular heartbeats, and strokes, which happen extremely seldom.

Cavotricuspid Isthmus Ablation ICD-10

The cavotricuspid isthmus ablation can be reported using the ICD-10-PCS codes shown below:

02580ZZ: Destruction of conduction mechanism, open approach

02583ZZ: Destruction of conduction mechanism, percutaneous approach

Cavotricuspid Isthmus Ablation CPT Code

The following CPT codes can be used to report cavotricuspid isthmus ablation:

93653: A thorough electrophysiologic evaluation that includes the placement and repositioning of multiple electrode catheters, the induction or attempted induction of an arrhythmia, right atrial and right ventricular pacing and recording, as well as His bundle recording when done, along with intracardiac catheter ablation of arrhythmogenic focus; for the treatment of atrial flutter by ablation of the cavotricuspid isthmus.

93654: A thorough electrophysiologic evaluation that includes the placement and repositioning of multiple electrode catheters, the induction or attempted induction of an arrhythmia, right atrial and right ventricular pacing and recording, and His bundle recording when done, along with intracardiac catheter ablation of arrhythmogenic focus; for the treatment of atrial flutter by ablation of sites other than the cavotricuspid isthmus (e.g., flutter circuits)