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Ann Thorac Surg 2000;69:S319-S331
© 2000 The Society of Thoracic Surgeons

Congenital Heart Surgery Nomenclature and Database Project: arrhythmias

Barbara J. Deal, MDa, Jeffrey P. Jacobs, MDb, Constantine Mavroudis, MDc

a Division of Pediatric Cardiology, Department of Pediatrics, Northwestern University Medical School, Children’s Memorial Hospital, Chicago, Illinois, USA
b Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital, University of South Florida College of Medicine, St. Petersburg, Florida, USA
c Division of Cardiovascular-Thoracic Surgery, Department of Surgery, Northwestern University Medical School, Children’s Memorial Hospital, Chicago, Illinois, USA

Address reprint requests to Dr Deal, Division of Cardiology, Children’s Memorial Hospital, 2300 Children’s Plaza, Chicago, IL 60614

Presented at the International Nomenclature and Database Conferences for Pediatric Cardiac Surgery, 1998–1999.

Abstract

This discussion of arrhythmia terminology attempts to classify rhythm disorders for which surgical therapy may be necessary. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery, for the purpose of establishing a unified reporting system. Efforts were made to include all relevant nomenclature categories, using synonyms where appropriate. Extant surgical ablative procedures, detailed methods of pacemaker insertion, and AICD technology are discussed. A comprehensive database set is presented that is based on a hierarchical scheme. Data are entered at various levels of complexity and detail, which can be determined by the clinician. These data can lay the foundation for comprehensive risk stratification analyses. A minimum database set is also presented, which will allow for data sharing and will lend itself to basic interpretation of trends. Outcome tables relating diagnoses, procedures, and various risk factors are presented.

I. Background

Arrhythmia terminology
This discussion of arrhythmia terminology attempts to classify rhythm disorders for which surgical therapy may be necessary. Diagnoses of associated cardiac structural abnormalities will be recognized by coding for prior surgeries. Postoperative complications will be addressed separately from this discussion, if they do not require surgical intervention. Complications requiring surgical intervention will be included in this database. Although the discussion of arrhythmia classification and terminology attempts to be inclusive, obviously not all diagnostic categories are presently amenable to catheter or surgical therapy, and will not be included in the coding section.

The appropriate choice of the descriptive term arrhythmia versus dysrhythmia, to describe disorders of cardiac rhythm or conduction, has been the subject of extensive discussion in the literature [1–5]. This paper will use The World Health Organization/International Society of Cardiology Task Force definition of arrhythmia as "any cardiac rhythm other than the normal sinus rhythm. Such a rhythm may be either of sinus or ectopic origin, and either regular or irregular. An arrhythmia may be due to a disturbance in impulse formation or conduction, or both" [6]. Based on the classical Greek meaning of arrhythmia as a "lack of, or imperfection of orderly and rhythmic conduction" [3, 4], and the traditional usage of the term arrhythmia, the term dysrhythmia has been called a "neologism, for which there is no good justification" [1], meant to "satisfy spurious scholarship" [3].

In a similar fashion, the use of the term paroxysmal atrial tachycardia (PAT) has largely been replaced by supraventricular tachycardia (SVT) to describe tachycardia using the atrium or atrioventricular junction [7, 8]. The use of the term SVT reflects the fact that such arrhythmias may not be paroxysmal (coming on in sudden, temporary attacks), and may not be strictly limited to atrial tissue.

Classification of SVT

Understanding of the various mechanisms responsible for SVT has resulted in multiple revisions of various classification schemes, as summarized by Wathen and colleagues [7]. Earlier approaches to the classification of SVT focused on description of the electrocardiographic appearance of the QRS complex: wide versus narrow, regular versus irregular, paroxysmal versus nonparoxysmal onset, and analysis of the P-QRS relationship [9, 10]. Classification based on more recent understanding of the cellular mechanisms responsible for tachycardia includes reentry, abnormal automaticity, and triggered reentry. At least 80% of clinical arrhythmias are reentrant in nature, involving a circuit with functionally distinct pathways with unidirectional block in one limb, allowing an electrical impulse to traverse the second limb and reenter the blocked pathway from the other direction [9]. Automatic rhythms demonstrate enhanced abnormal automaticity, or firing of a relatively discrete focus, and account for less than 10% of clinical SVT [9, 11, 12]. However, clinical practice may not allow precise definition of the mechanism, but rather an approximation of the likely mechanism [7]. Anatomically based classification distinguishes atrial from junctional tachycardia. Atrial tachycardia uses only atrial tissue for initiation and maintenance of tachycardia, and is independent of atrioventricular conduction (eg, atrial flutter) [7]. Junctional tachycardia requires the atrioventricular junction as a necessary component of the tachycardia circuit (eg, atrioventricular nodal reentry or accessory connection-mediated tachycardia) [7]. A practical classification scheme for SVT, combining anatomic and mechanistic considerations is summarized as follows:

Primary atrial tachycardia
Sinus
Automatic atrial
Atrial reentry
Atrial flutter
Atrial fibrillation
Multifocal atrial

AV nodal tachycardia
AV nodal reentry (AVNRT)
Typical: Slow-fast
Atypical: Fast-slow

AV junctional: automatic
Junctional ectopic


Accessory connection-mediated tachycardia
Orthodromic reciprocating tachycardia (ORT)
Permanent form of junctional reciprocating tachycardia (PJRT)

Antidromic reciprocating tachycardia
Preexcitation variants

Primary atrial tachycardia includes rhythms where the electrical disturbance is confined to atrial tissue, and tachycardia persists in the setting of atrioventricular block. Such rhythms may be reentrant in nature, such as atrial flutter, or atrial reentry, as seen in patients with prior atrial operation, and atrial fibrillation; or automatic, such as automatic (ectopic) atrial tachycardia, often associated with cardiomyopathy.

AV nodal tachycardia includes the common atrioventricular (AV) nodal reentry tachycardia using dual AV nodal physiology, as well as the automatic junctional ectopic tachycardia that occurs postoperatively, or rarely in a congenital form.

Accessory connection mediated tachycardia includes patients with Wolff-Parkinson-White syndrome (manifest preexcitation present on the resting electrocardiogram) as well as concealed accessory connections and preexcitation variants. Successful surgical and catheter treatment of accessory-connection mediated tachycardia, associated with the Wolff-Parkinson-White (WPW) syndrome, formed the basis for understanding reentry tachycardia, with the reentrant circuit utilizing the atria, atrioventricular node, and ventricles [13]. The nomenclature for ventricular preexcitation has included Kent bundles, bypass tracts, Mahaim fibers, James fibers, and accessory pathways [14, 15]. The term atrioventricular accessory connection is generally acceptable [15] with further classification based on anatomical location of the accessory connection: septal (anteroseptal, midseptal, and posteroseptal), right or left free wall (anterior, lateral, posterior). The accessory connection is further characterized by the presence or absence of preexcitation during sinus-rhythm by the terms manifest or concealed preexcitation. The interpretation of WPW on electrocardiogram implies manifest preexcitation during sinus rhythm.

The classification of SVT by type is important due to the distinctive clinical implications of the different arrhythmias. The age-related incidence of the various types of SVT is summarized in Table 1.


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  		Table 1. Age-Related Incidence of Supraventricular Tachycardia

 
In childhood, accessory connection-mediated tachycardia accounts for at least 80% of SVT, consistent with the congenital basis of the accessory connection [12]. By adulthood, AV nodal reentry tachycardia is the mechanism of at least 50% of clinical SVT, correlating with the development of dual AV nodal physiology with age [9, 11, 16]. The presence of congenital heart disease, particularly in the postoperative setting, is associated with junctional ectopic tachycardia acutely postoperatively, or the later development of atrial reentry tachycardia, often involving an atrial incision. The natural history of tachycardia varies by type, with spontaneous resolution in some forms, such as accessory connection-mediated tachycardia presenting in infancy, favoring pharmacologic therapy. The risk of sudden death, due to rapid conduction of SVT to the ventricles, is associated with manifest preexcitation [17], and forms the basis of risk stratification and aggressive treatment in patients with Wolff-Parkinson-White syndrome. Finally, success rates for cure of tachycardia using ablation techniques vary with the type of SVT, and recurrence rates following ablation vary with accessory connection location [18, 19].

Classification of AV conduction disorders and ventricular tachycardia
The classification of AV conduction disorders is relatively straightforward, divided into congenital and acquired disorders, including postoperative heart block. The degree of AV conduction disorder is further characterized as first, second, or third degree block. A recent summary of conduction disorders has been published by Friedman [20].

The classification of ventricular tachycardia (VT) is becoming more complex, based on predisposing causes (eg, postoperative tetralogy of Fallot, myocardial infarction), site of origin (eg, right ventricular outflow tract), improved understanding of mechanisms (eg, adenosine-sensitive), and identification of genetic ion-channel defects (eg, long QT syndrome, Brugada’s syndrome) [21, 22]. A classification scheme for ventricular tachycardia is summarized as follows:

Scar-mediated
Postsurgical
Tetralogy of Fallot
Double outlet right ventricle

Postinfarction

Cardiomyopathy
Right ventricular dysplasia
Dilated
Bundle branch reentry

Hypertrophic

Long QT syndrome
Idiopathic
Right ventricular outflow
Left ventricular outflow
Septal (Belhassen’s)

Idiopathic ventricular fibrillation
Brugada’s syndrome
Inflammatory

The present surgical options for treatment of VT are comparatively limited, including resection or isolation, ablation, and defibrillator implantation [23–25]. In patients with postoperative congenital heart disease, improvement of residual hemodynamic defects, such as relief of right ventricular hypertension in patients with repaired tetralogy of Fallot, may be an important part of the therapy for ventricular arrhythmias [26, 27].

II. Analysis: a unified nomenclature system for arrhythmias

Arrhythmia hierarchy level 1

Arrhythmia, Not otherwise specified (NOS)
Arrhythmia, Atrial
Arrhythmia, Ventricular
Arrhythmia, Atrioventricular conduction disorders
Arrhythmia, Device

Arrhythmia hierarchy level 2

Arrhythmia, NOS
Arrhythmia, Atrial NOS

Arrhythmia, Atrial, SVT

Arrhythmia Ventricular NOS

Arrhythmia, Ventricular, Tachycardia
Arrhythmia, Ventricular, Long QT syndrome
Arrhythmia, Ventricular, Fibrillation

Arrhythmia, Atrioventricular conduction disorders,
NOS

Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction)
Arrhythmia, Atrioventricular conduction disorders, AV block

Arrhythmia, Device NOS

Arrhythmia, Device, Implanted pacemaker
Arrhythmia, Device, Implanted AICD

Arrhythmia hierarchy level 3

Arrhythmia, NOS
Arrhythmia, Atrial, NOS
Arrhythmia, Atrial, SVT, NOS

Arrhythmia, Atrial, SVT, Primary atrial tachycardia
Arrhythmia, Atrial, SVT, AV nodal tachycardia
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia

Arrhythmia, Ventricular, NOS
Arrhythmia, Ventricular, Tachycardia, NOS

Arrhythmia, Ventricular, Tachycardia, Oncogenic (tumor)
Arrhythmia, Ventricular, Tachycardia, Primary
Arrhythmia, Ventricular, Tachycardia, Postoperative
Arrhythmia, Ventricular, Tachycardia, Postinfarction
Arrhythmia, Ventricular, Tachycardia, Cardiomyopathy
Arrhythmia, Ventricular, Tachycardia, Myocarditis
Arrhythmia, Ventricular, Tachycardia, Other

Arrhythmia, Ventricular, Long QT syndrome
Arrhythmia, Ventricular, Fibrillation
Arrhythmia, Atrioventricular conduction disorders, NOS
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), NOS

Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), Primary
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), Acquired (postoperative)

Arrhythmia, Atrioventricular conduction disorders, AV block, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, First degree
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2
Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree

Arrhythmia, Device, NOS
Arrhythmia, Device, Implanted, Pacemaker, NOS

Arrhythmia, Device, Implanted Pacemaker, End of life
Arrhythmia, Device, Implanted Pacemaker, Malfunction
Arrhythmia, Device, Implanted Pacemaker, Infection
Arrhythmia, Device, Implanted Pacemaker, NOS

Arrhythmia, Device, Implanted, AICD, NOS

Arrhythmia, Device, Implanted AICD, End of life
Arrhythmia, Device, Implanted AICD, Malfunction
Arrhythmia, Device, Implanted AICD, Infection
Arrhythmia, Device, Implanted, AICD, NOS

Arrhythmia hierarchy level 4

Arrhythmia, NOS
Arrhythmia, Atrial, NOS
Arrhythmia, Atrial, SVT, NOS
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, NOS

Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Sinus
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Automatic atrial
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Atrial reentry
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Atrial flutter
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Atrial fibrillation
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Multifocal atrial

Arrhythmia, Atrial, SVT, AV nodal tachycardia, NOS

Arrhythmia, Atrial, SVT, AV nodal tachycardia, AV nodal reentry tachycardia (AVNRT)
Arrhythmia, Atrial, SVT, AV nodal tachycardia, Automatic junctional

Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, NOS

Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Manifest (WPW)
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Concealed

Arrhythmia, Ventricular, NOS
Arrhythmia, Ventricular, Tachycardia, NOS
Arrhythmia, Ventricular, Tachycardia, Oncogenic (tumor)
Arrhythmia, Ventricular, Tachycardia, Primary
Arrhythmia, Ventricular, Tachycardia, Postoperative
Arrhythmia, Ventricular, Tachycardia, Postinfarction
Arrhythmia, Ventricular, Tachycardia, Cardiomyopathy
Arrhythmia, Ventricular, Tachycardia, Myocarditis
Arrhythmia, Ventricular, Tachycardia, Other
Arrhythmia, Ventricular, Long QT syndrome
Arrhythmia, Ventricular, Fibrillation
Arrhythmia, Atrioventricular conduction disorders, NOS
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), NOS
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), Primary
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), Acquired (Postoperative)
Arrhythmia, Atrioventricular conduction disorders, AV block, NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Acquired

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Acquired

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Acquired

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Acquired

Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Acquired

Arrhythmia, Device, NOS
Arrhythmia, Device Implanted Pacemaker, NOS
Arrhythmia, Device, Implanted Pacemaker, End of life
Arrhythmia, Device, Implanted Pacemaker, Malfunction
Arrhythmia, Device, Implanted Pacemaker, Infection
Arrhythmia, Device, Implanted AICD, NOS
Arrhythmia, Device, Implanted AICD, End of life
Arrhythmia, Device, Implanted AICD, Malfunction
Arrhythmia, Device, Implanted AICD, Infection

Arrhythmia hierarchy level 5

Arrhythmia, NOS
Arrhythmia, Atrial, NOS
Arrhythmia, Atrial, SVT, NOS
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, NOS
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Sinus
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Automatic atrial
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Atrial reentry
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Atrial flutter
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Atrial fibrillation
Arrhythmia, Atrial, SVT, Primary atrial tachycardia, Multifocal atrial
Arrhythmia, Atrial, SVT, AV nodal tachycardia, NOS
Arrhythmia, Atrial, SVT, AV nodal tachycardia, AV nodal reentry tachycardia (AVNRT), NOS

Arrhythmia, Atrial, SVT, AV nodal tachycardia, AV nodal reentry tachycardia (AVNRT), Typical: slow-fast
Arrhythmia, Atrial, SVT, AV nodal tachycardia, AV nodal reentry tachycardia (AVNRT), Atypical: fast-slow

Arrhythmia, Atrial, SVT, AV nodal tachycardia, Automatic junctional, NOS

Arrhythmia, Atrial, SVT, AV nodal tachycardia, Automatic junctional, Junctional ectopic tachycardia (JET)

Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, NOS
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Manifest (WPW), NOS

Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Manifest (WPW), Left free wall
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Manifest (WPW), Septal
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Manifest (WPW), Right free wall

Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Concealed, NOS

Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Concealed, Left free wall
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Concealed, Septal
Arrhythmia, Atrial, SVT, Accessory connection-mediated tachycardia, Concealed, Right free wall

Arrhythmia, Ventricular, NOS
Arrhythmia, Ventricular, Tachycardia, NOS
Arrhythmia, Ventricular, Tachycardia, Oncogenic (tumor)
Arrhythmia, Ventricular, Tachycardia, Primary
Arrhythmia, Ventricular, Tachycardia, Postoperative
Arrhythmia, Ventricular, Tachycardia, Postinfarction
Arrhythmia, Ventricular, Tachycardia, Cardiomyopathy
Arrhythmia, Ventricular, Tachycardia, Myocarditis
Arrhythmia, Ventricular, Tachycardia, Other
Arrhythmia, Ventricular, Long QT syndrome
Arrhythmia, Ventricular, Fibrillation
Arrhythmia, Atrioventricular conduction disorders, NOS
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (sinus node dysfunction), NOS
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), Primary
Arrhythmia, Atrioventricular conduction disorders, Sick sinus syndrome (SSS) (Sinus node dysfunction), Acquired (Postoperative)
Arrhythmia, Atrioventricular conduction disorders, AV block, NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Acquired, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Acquired, Surgical
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Acquired, Myocarditis
Arrhythmia, Atrioventricular conduction disorders, AV block, First degree, Acquired, Other

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Acquired

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Acquired, Surgical
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Acquired, Myocarditis
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree NOS, Acquired, Other

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Acquired, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Acquired, Surgical
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Acquired, Myocarditis
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 1, Acquired, Other

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Acquired, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Acquired, Surgical
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Acquired, Myocarditis
Arrhythmia, Atrioventricular conduction disorders, AV block, Second degree Mobitz 2, Acquired, Other

Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, NOS
Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Congenital
Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Acquired, NOS

Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Acquired, Surgical
Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Acquired, Myocarditis
Arrhythmia, Atrioventricular conduction disorders, AV block, Third degree, Acquired, Other

Arrhythmia, Device, NOS
Arrhythmia, Device Implanted Pacemaker, NOS
Arrhythmia, Device, Implanted Pacemaker, End of life
Arrhythmia, Device, Implanted Pacemaker, Malfunction
Arrhythmia, Device, Implanted Pacemaker, Infection
Arrhythmia, Device, Implanted AICD, NOS
Arrhythmia, Device, Implanted AICD, End of life
Arrhythmia, Device, Implanted AICD, Malfunction
Arrhythmia, Device, Implanted AICD, Infection

III. Nomenclature for treatment options for arrhythmias

Arrhythmia treatment hierarchy level 1

Arrhythmia—Atrial, Surgical ablation
Arrhythmia—Ventricular, Surgical ablation
ICD (AICD) Implantation
Pacemaker Implantation, Permanent

Arrhythmia treatment hierarchy level 2

Arrhythmia—Atrial, Surgical ablation, NOS

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation

Arrhythmia—Ventricular, Surgical ablation, NOS

Arrhythmia—Ventricular, Surgical ablation, Endocardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Epicardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Tumor resection

ICD (AICD) Implantation, NOS

ICD (AICD) Implantation, Epicardial
ICD (AICD) Implantation, Transmural
ICD (AICD) Implantation, Transvenous

Pacemaker Implantation, Permanent, NOS

Pacemaker Implantation, Permanent, Epicardial
Pacemaker Implantation, Permanent, Transmural
Pacemaker Implantation, Permanent, Transvenous

Arrhythmia treatment hierarchy level 3

Arrhythmia—Atrial, Surgical ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, NOS

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation

Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, NOS

Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, Cryoablation modification
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, Dissection modification

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, NOS

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedure for atrial flutter

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, NOS

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, Maze or Maze-Cox procedure using dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, Other arrhythmia procedure for atrial fibrillation using dissection and/or cryoablation

Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, NOS

Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, Surgical excision
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, Cryoablation

Arrhythmia—Ventricular, Surgical ablation, NOS
Arrhythmia—Ventricular, Surgical ablation, Endocardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Epicardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Tumor resection
ICD (AICD) Implantation, NOS
ICD (AICD) Implantation, Epicardial, NOS

ICD (AICD) Implantation, Epicardial, Atrial
ICD (AICD) Implantation, Epicardial, Ventricular

ICD (AICD) Implantation, Transmural, NOS

ICD (AICD) Implantation, Transmural, Atrial
ICD (AICD) Implantation, Transmural, Ventricular

ICD (AICD) Implantation, Transvenous, NOS

ICD (AICD) Implantation, Transvenous, Atrial
ICD (AICD) Implantation, Transvenous, Ventricular

Pacemaker Implantation, Permanent, NOS
Pacemaker Implantation, Permanent, Epicardial, NOS

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid
Pacemaker Implantation, Permanent, Epicardial, Sternotomy
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy

Pacemaker Implantation, Permanent, Transmural, NOS

Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads
Pacemaker Implantation, Permanent, Transmural, Atrial lead only
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only

Pacemaker Implantation, Permanent, Transvenous, NOS

Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only

Arrhythmia treatment hierarchy level 4

Arrhythmia—Atrial, Surgical ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation, NOS

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation, Epicardial approach with or without cardiopulmonary bypass (CPB)

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation, NOS

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation, Epicardial approach with or without cardiopulmonary bypass (CPB)

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation, NOS

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation, Epicardial approach with or without cardiopulmonary bypass (CPB)

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation, NOS

Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation, Epicardial approach with or without cardiopulmonary bypass (CPB)

Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, NOS
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, Cryoablation modification
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, Dissection modification
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, NOS

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, Surgical incisions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, Cryoablation lesions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, Both surgical incisions and cryoablation lesions

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedure for atrial flutter, NOS

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedure for atrial flutter, Surgical incisions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedure for atrial flutter, Cryoablation lesions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedure for atrial flutter, Both surgical incisions and cryoablation lesions

Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, Maze or Maze-Cox procedure using dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, Other arrhythmia procedure for atrial fibrillation using dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, Surgical excision
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, Cryoablation
Arrhythmia—Ventricular, Surgical ablation, NOS
Arrhythmia—Ventricular, Surgical ablation, Endocardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Epicardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Tumor resection
ICD (AICD) Implantation, NOS
ICD (AICD) Implantation, Epicardial, NOS
ICD (AICD) Implantation, Epicardial, Atrial
ICD (AICD) Implantation, Epicardial, Ventricular
ICD (AICD) Implantation, Transmural, NOS
ICD (AICD) Implantation, Transmural, Atrial
ICD (AICD) Implantation, Transmural, Ventricular
ICD (AICD) Implantation, Transvenous, NOS
ICD (AICD) Implantation, Transvenous, Atrial
ICD (AICD) Implantation, Transvenous, Ventricular
Pacemaker Implantation, Permanent, NOS
Pacemaker Implantation, Permanent, Epicardial, NOS
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, NOS

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial and ventricular leads
Pacemaker Implantation Permanent, Epicardial, Subxiphoid, Atrial lead only
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Ventricular lead only

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, NOS

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial and ventricular leads
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial lead only
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Ventricular lead only

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, NOS

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial and ventricular leads
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial lead only
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Ventricular lead only

Pacemaker Implantation, Permanent, Transmural, NOS
Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads, NOS

Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads, DDDR

Pacemaker Implantation, Permanent, Transmural, Atrial Lead Only, NOS

Pacemaker Implantation, Permanent, Transmural, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Transmural, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Transmural, Atrial lead only, AAIT

Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, NOS

Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, VVIR

Pacemaker Implantation, Permanent, Transvenous, NOS
Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads, NOS

Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads, DDDR

Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, NOS

Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, AAIT

Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, NOS

Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, VVIR
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, DDD

Arrhythmia treatment hierarchy level 5

Arrhythmia—Atrial, Surgical ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Left free wall dissection and/or cryoablation, Epicardial approach with or without CPB
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Right free wall dissection and/or cryoablation, Epicardial approach with or without CPB
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Posteroseptal dissection and/or cryoablation, Epicardial approach with or without CPB
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation, NOS
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation, Endocardial approach
Arrhythmia—Atrial, Surgical ablation, Accessory connection ablation, Anteroseptal dissection and/or cryoablation, Epicardial approach with or without CPB
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, NOS
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, Cryoablation modification
Arrhythmia—Atrial, Surgical ablation, AV nodal reentry modification, Dissection modification
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, Surgical incisions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, Cryoablation lesions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Modified or unmodified right sided Maze procedure, Both surgical incisions and cryoablation lesions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedures for atrial flutter, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedures for atrial flutter, Surgical incisions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedures for atrial flutter, Cryoablation lesions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial flutter (atrial reentry tachycardia) ablation, Other arrhythmia procedures for atrial flutter, Both surgical incisions and cryoablation lesions
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, Maze or Maze-Cox Procedure using dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Procedure for atrial fibrillation ablation, Other arrhythmia procedure for atrial fibrillation using dissection and/or cryoablation
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, NOS
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, Surgical excision
Arrhythmia—Atrial, Surgical ablation, Procedure for supraventricular arrhythmogenic focus ablation, Cryoablation
Arrhythmia—Ventricular, Surgical ablation, NOS
Arrhythmia—Ventricular, Surgical ablation, Endocardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Epicardial resection, isolation and/or cryoablation
Arrhythmia—Ventricular, Surgical ablation, Tumor resection
ICD (AICD) Implantation, NOS
ICD (AICD) Implantation, Epicardial, NOS
ICD (AICD) Implantation, Epicardial, Atrial
ICD (AICD) Implantation, Epicardial, Ventricular
ICD (AICD) Implantation, Transmural, NOS
ICD (AICD) Implantation, Transmural, Atrial
ICD (AICD) Implantation, Transmural, Ventricular
ICD (AICD) Implantation, Transvenous, NOS
ICD (AICD) Implantation, Transvenous, Atrial
ICD (AICD) Implantation, Transvenous, Ventricular
Pacemaker Implantation, Permanent, NOS
Pacemaker Implantation, Permanent, Epicardial, NOS
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, NOS
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial and ventricular leads, NOS

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial and ventricular leads, DDDR

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial leads only, NOS

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Atrial lead only, AAIT

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Ventricular lead only, NOS

Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Epicardial, Subxiphoid, Ventricular lead only, VVIR

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, NOS
Pacemaker Implantation, Permanent, Epicardial,
Sternotomy, Atrial and ventricular leads, NOS

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial and ventricular leads, DDDR

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial lead only, NOS

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Atrial lead only, AAIT

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Ventricular lead only, NOS

Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Epicardial, Sternotomy, Ventricular lead only, VVIR

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, NOS
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial and ventricular leads, NOS

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial and ventricular leads, DDDR

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial lead only, NOS

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Atrial lead only, AAIT

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Ventricular lead only, NOS

Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Epicardial, Thoracotomy, Ventricular lead only, VVIR

Pacemaker Implantation, Permanent, Transmural, NOS
Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads, NOS
Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Transmural, Atrial and ventricular leads, DDDR
Pacemaker Implantation, Permanent, Transmural, Atrial lead only, NOS
Pacemaker Implantation, Permanent, Transmural, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Transmural, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Transmural, Atrial lead only, AAIT
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, NOS
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Transmural, Ventricular lead only, VVIR
Pacemaker Implantation, Permanent, Transvenous, NOS
Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads, NOS
Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads, DDD
Pacemaker Implantation, Permanent, Transvenous, Atrial and ventricular leads, DDDR
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, NOS
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, AAI
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, AAIR
Pacemaker Implantation, Permanent, Transvenous, Atrial lead only, AAIT
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, NOS
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, DVI
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, DVIR
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, VVI
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, VVIR
Pacemaker Implantation, Permanent, Transvenous, Ventricular lead only, DDD

IV. Diagnosis and procedure short lists

Diagnosis Short List
Arrhythmia
Arrhythmia, Heart block, NOS
Arrhythmia, Heart block, Acquired
Arrhythmia, Heart block, Congenital
Arrhythmia, Pacemaker, Indication for replacement

Procedure Short List
Arrhythmia—Atrial, Surgical ablation
Arrhythmia—Ventricular, Surgical ablation
ICD (AICD) Implantation
Pacemaker Implantation, Permanent

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