CPT® Code 93650

Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement

The procedure described by CPT® Code 93650 involves the use of intracardiac catheter ablation targeting the atrioventricular (AV) node function and/or atrioventricular conduction. This intervention is specifically aimed at creating a complete heart block, which is a controlled disruption of the electrical signals that coordinate the heart's rhythm. The primary indication for this procedure is the treatment of patients suffering from atrial fibrillation, a condition characterized by an irregular and often rapid heart rate. During the procedure, specialized ablation catheters are introduced into the heart, typically positioned at the AV junction through either a transaortic or transseptal approach. The ablation process employs either radiofrequency energy or cryoablation techniques to effectively interrupt the conduction pathways of electrical impulses, thereby establishing a complete right heart block. This is achieved by inducing arrhythmia, followed by repositioning the catheter as necessary, and repeating the ablation until the desired complete AV block is confirmed by the inability to induce arrhythmia. In some cases, a temporary pacemaker may be utilized to manage the resultant AV block, ensuring that the heart maintains an adequate rhythm during the recovery phase.