Further details of the study design, setting, and participants have been previously published. All other participants provided written consent or verbal consent by telephone. The Group Health Human Subjects Review Committee approved this study and granted a waiver of consent for participants with language or cognitive difficulty and for participants who had died. We excluded AF that was not of new onset, perioperative AF that resolved by hospital discharge, AF that occurred after pacemaker implantation, and AF that occurred as part of a hospitalized terminal illness. Based on this medical record review, we included patients whose initial AF or atrial flutter episode was confirmed by 12‐lead electrocardiogram and recognized by a physician. Using a standardized medical record abstraction form, abstractors trained by one of the authors (SRH) reviewed each participant's diagnosis and confirmed study eligibility by medical record review. Patients were first identified by appearance of an inpatient or outpatient International Classification of Diseases, Ninth Revision (ICD‐9) code for AF (427.31) or atrial flutter (427.32) in Group Health administrative databases. We studied patients residing in western Washington state who experienced their first electrocardiogram‐confirmed AF episode between October 2001 and December 2004 and were age 30 to 84 years. Hence, the purpose of our study was to assess accuracy of electrical cardioversion and ablation/maze procedure codes in administrative billing data relative to documentation of these procedures in medical records in an integrated healthcare system. 5 Having searched the literature, we are not aware of any prior study assessing accuracy of billing codes for electrical cardioversion. These procedures are documented in medical records but can also be ascertained from administrative billing codes for research conducted in integrated healthcare systems or health insurance databases.Īlthough billing codes for ablation/maze procedures have been used in several research studies, 1, 2, 3, 4 few researchers have investigated their accuracy. For example, among patients initially identified with an episode of paroxysmal AF who then revert to sinus rhythm, occurrence of electrical cardioversion or ablation/maze later during follow‐up would indicate that AF had recurred and required intervention. For researchers studying AF prognosis and treatment, detecting the occurrence of these procedures can help characterize AF progression during follow‐up of patients. In atrial fibrillation (AF) patients, electrical cardioversion and AF ablation/maze procedures are important methods of restoring normal heart rhythm.
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