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IMPACT Registry
March 15, 2017
8:00 am – 9:30 am
EP Module Considerations
Presenters:
Robert N. Vincent, MD, CM, FACC
Elizabeth Saarel, MD
Melissa Nitta, MPH, BS, RN
Objectives:
1. Discuss IMPACT Registry status and statistics.
2. Discuss challenging data elements and scenarios.
3. Demonstrate data abstraction knowledge through use of an audience response system.
Pre-Work:
1. Review Section L Electrophysiology Procedure of the data collection form
2. Review the Data Dictionary Definitions for Seq#10000 (Primary Procedure Indication) through
Seq#10135 (Number of Ablation Activations)
3. Identify areas of interest or concern for discussion pertaining to electrophysiology procedures
Notes/Outline:
I.
Primary Procedure Indication
a. Evaluation of specific arrhythmia
b. Evaluation of event or symptoms suggesting arrhythmia
c. Evaluation of prior antiarrhythmic treatment
d. Evaluation of risk for ventricular tachyarrhythmia
e. Preoperative evaluation
II.
History of Congenital Heart Disease
a. No structural heart disease or trivial, unoperated congenital heart disease
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b. Repaired functionally two-ventricle congenital heart disease
c. Repaired tetralogy of Fallot and tetralogy-like variants
d. Transposition of the great arteries following atrial-level (Mustard or Senning) palliation
e. Fontan palliation of functionally univentricular heart
f.
Pre-Fontan palliation of functionally univentricular heart
g. Unoperated acyanotic congenital heart disease
h. Unoperated cyanotic congenital heart disease
III.
Targeted Ablation Substrate(s)
IV.
Patient scenarios
V.
Q&A
Frequently Used Terminology:
Symptom Severity Survey (SSS) – an assessment of a patient’s functional capabilities and rhythm
related symptoms
Ablation – scarring or destroying tissue (usually using heat or cold energy) that is critical for generation
and maintenance of an arrhythmia
Target – the area chosen to receive the ablation energy
Targeted Substrate – the tissue type of the target (e.g., atrial myocardium, accessory pathway,
atrioventricular node, etc).
Activation mapping – determination of the source or path of the arrhythmia by assessing the activation
timing in different areas of a heart chamber relative to a reference point (aka - an elaborate game of
“hotter” and “colder”)
Anatomic mapping – Use of anatomic landmarks to target an arrhythmia source or path.
Signal morphology mapping – Use of intra-cardiac electrogram or surface electrocardiogram signal
features to identify the source or path of an arrhythmia
Pace mapping – Activating the heart in different areas and assessing how well the activated region
mimics the appearance of the arrhythmia.
Voltage (substrate) mapping – Measuring the amplitude of the electrical signal in different areas of a
heart chamber to identify regions that have been injured or scarred.
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Action Items:
Please complete the following activities after attending this session:
1. Take this opportunity to network with fellow participants:
 Visit the posters→ask for contact information→learn what could work at your
facility
 Meet the participant presenters→ask for contact information→learn if what they
did would work at your facility
2. Establish or continue to cultivate a relationship with the EP clinical staff to facilitate accurate
data collection
3. Visit the IMPACT Registry website Resource Page and the subsequent pages (below) to locate
data abstraction resources.
 Documents (v2)
 FAQ (v2)
 Meeting Minutes
 Education
 Participant Directory
4. Join the monthly Registry Site Manager calls occurring the 4th Monday of nearly every month
for updates and discussion. The schedule is found on the ‘Education’ page and the dial-in
information appears on the registry landing page prior to the call.
5. Check out the Monthly Case Scenario posted to the Education page at the start of each month,
it highlights a specific data element, metric or consideration of the registry.
6. Identify challenging data elements
 Clarify coding directives by emailing the NCDR
 Collate resources useful for understanding/coding and disseminate to all abstractors
internally
 Update prn
7. Question(s)? Email [email protected]
Resources:


Data Collection Form v2.0.1
Data Dictionary Full Specifications v2.0.1
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