DNA Databank Demonstration Project
Atrial fibrillation
Data source summary:
Cases
Possible/
Probable
Controls
Excluded
from
Analysis
Diagnostic
Codes?
Yes (Absence
of codes)
Yes
Text
Keywords?
Disease
only
Disease
only
Yes(Absence
of codes)
Yes
Disease
only
Disease
only
Narrative Notes to search
Other rules
ECG Impression
ECG Impression, H&P,
Discharge summary, all notes
ECG Impression, H&P,
Discharge summary, all notes
ECG Impression, H&P,
Discharge summary, all notes
May require
manual curation
of all records
Must have ECG
Pre-Analysis: Validation of impression with diagnosis
CASES:
Case Definition:
ECG Impression = Atrial Fibrillation keywords
AND NOT
CPT/ICD 9 codes = heart transplant
Subcase 1:
ECG Impression = Atrial Fibrillation keywords
AND NOT
(ECG Impression = Myocardial infarction keywords within 14 days (pre or post)
OR
CPT/ICD 9 codes = cardiac surgery)
Subcase 2:
ECG Impression = Atrial Fibrillation keywords
AND
(ECG Impression = Myocardial infarction keywords within 14 days (pre or post)
OR
CPT/ICD 9 codes = cardiac surgery)
Page 1 of 10
Case/Possible:
Text of notes = Atrial Fibrillation or atrial flutter
OR
ICD 9 codes = Atrial Fibrillation or atrial flutter
CONTROLS:
Record contains none of the above
AND NOT
ICD-9 codes = Atrial flutter / atrial fibrillation
AND NOT
Keywords = Atrial flutter, Atrial tachycardia
Note: Record must contain at least one ECG (without AF keywords)
INDEX
Case Keywords (any of the below) for ECGs:
REGEXP_LIKE(IMPRESSION,'((^|[ \.])AF($|[ \.]))|(a\w*[ .]?(fib[\w]*|flutter))','i')
This should match:
Afib
A* fib*
AF
Aflutter
A* flutter
Case Possible Keywords (any of the below):
Atrial fibrillation [fibrulation] [fabrillation] [fibrilation]; A fibrillation; A fib; afib; Atrial
fib; atr fib*, auricular fib*; aflutter, atrial flutter
Control Keywords (any of the below):
Atrial flutter; A Flutter; Aflutter; AFL; Direct current cardioversion; Cardioverted;
DCCV; DC cardioversion; Shocked; Atrial tachycardia1 [tachyardia] [tachychardia]
[tachyacardia] [tachycardic]; Atach; MAT; Multifocal atrial tachycardia; Atrioventricular
nodal [node] ablation [oblation]; AV nodal ablation; nodal catheter ablation
Case CPT codes (any of the below)
Description
CPT Code
“AT” will not be used - obviously will be tough because there will be so many 'at' references in the med
record
1
Page 2 of 10
Anesthesia for direct coronary artery bypass grafting without pump
oxygenator
Thoracotomy, major; with cardiac massage
Excision of intracardiac tumor, resection with cardiopulmonary bypass
Resection of external cardiac tumor
Transmyocardial laser revascularization, by thoracotomy; performed at
the time of other open cardiac procedure(s) (List separately in addition
to code for primary procedure)
Operative tissue ablation and reconstruction of atria, performed at the
time of other cardiac procedure(s), limited (eg, modified maze
procedure) (List separately in addition to code for primary procedure)
Operative tissue ablation and reconstruction of atria, performed at the
time of other cardiac procedure(s), extensive (eg, maze procedure),
without cardiopulmonary bypass (List separately in addition to code for
primary procedure)
Operative tissue ablation and reconstruction of atria, performed at the
time of other cardiac procedure(s), extensive (eg, maze procedure), with
cardiopulmonary bypass (List separately in addition to code for primary
procedure)
Repair of cardiac wound; without bypass
Repair of cardiac wound; with cardiopulmonary bypass
Cardiotomy, exploratory (includes removal of foreign body, atrial or
ventricular thrombus); without bypass
Cardiotomy, exploratory (includes removal of foreign body, atrial or
ventricular thrombus); with cardiopulmonary bypass
Valvuloplasty, aortic valve; open, with cardiopulmonary bypass
Valvuloplasty, aortic valve; open, with inflow occlusion
Valvuloplasty, aortic valve; using transventricular dilation, with
cardiopulmonary bypass
Construction of apical-aortic conduit
Replacement, aortic valve, with cardiopulmonary bypass; with
prosthetic valve other than homograft or stentless valve
Replacement, aortic valve, with cardiopulmonary bypass; with allograft
valve (freehand)
Replacement, aortic valve, with cardiopulmonary bypass; with stentless
tissue valve
Replacement, aortic valve; with aortic annulus enlargement,
noncoronary cusp
Replacement, aortic valve; with transventricular aortic annulus
enlargement (Konno procedure)
Replacement, aortic valve; by translocation of autologous pulmonary
valve with allograft replacement of pulmonary valve (Ross procedure)
Resection or incision of subvalvular tissue for discrete subvalvular
aortic stenosis
566
32160
33120
33130
33141
33257
33258
33259
33300
33305
33310
33315
33400
33401
33403
33404
33405
33406
33410
33411
33412
33413
33415
Page 3 of 10
Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic
stenosis (eg, asymmetric septal hypertrophy)
Valvotomy, mitral valve; closed heart
Valvotomy, mitral valve; open heart, with cardiopulmonary bypass
Valvuloplasty, mitral valve, with cardiopulmonary bypass;
Valvuloplasty, mitral valve, with cardiopulmonary bypass; with
prosthetic ring
Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical
reconstruction, with or without ring
Replacement, mitral valve, with cardiopulmonary bypass
Valvectomy, tricuspid valve, with cardiopulmonary bypass
Valvuloplasty, tricuspid valve; without ring insertion
Valvuloplasty, tricuspid valve; with ring insertion
Replacement, tricuspid valve, with cardiopulmonary bypass
Tricuspid valve repositioning and plication for Ebstein anomaly
Valvotomy, pulmonary valve, closed heart; transventricular
Valvotomy, pulmonary valve, closed heart; via pulmonary artery
Valvotomy, pulmonary valve, open heart; with inflow occlusion
Valvotomy, pulmonary valve, open heart; with cardiopulmonary bypass
Replacement, pulmonary valve
Repair of coronary arteriovenous or arteriocardiac chamber fistula; with
cardiopulmonary bypass
Repair of coronary arteriovenous or arteriocardiac chamber fistula;
without cardiopulmonary bypass
REPAIR OF ANOMALOUS AORTIC ORIGIN OF CORONARY
ARTERY BY UNROOF OR TRANSLOCA Repair of anomalous (eg,
intramural) aortic origin of coronary artery by unroofing or translocation
Coronary endarterectomy, open, any method, of left anterior descending,
circumflex, or right coronary artery performed in conjunction with
coronary artery bypass graft procedure, each vessel (List separately in
addition to primary procedure)
Closure of atrioventricular valve (mitral or tricuspid) by suture or patch
Closure of semilunar valve (aortic or pulmonary) by suture or patch
Repair of complex cardiac anomaly other than pulmonary atresia with
ventricular septal defect by construction or replacement of conduit from
right or left ventricle to pulmonary artery
Repair of complex cardiac anomalies (eg, single ventricle with subaortic
obstruction) by surgical enlargement of ventricular septal defect
Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of
atrial septal defect and anastomosis of atria or vena cava to pulmonary
artery (simple Fontan procedure)
Repair of complex cardiac anomalies (eg, single ventricle) by modified
Fontan procedure
33416
33420
33422
33425
33426
33427
33430
33460
33463
33464
33465
33468
33470
33471
33472
33474
33475
33500
33501
33507
33572
33600
33602
33608
33610
33615
33617
Page 4 of 10
Repair of single ventricle with aortic outflow obstruction and aortic arch
hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure)
Repair atrial septal defect, secundum, with cardiopulmonary bypass,
with or without patch
Repair of atrial septal defect and ventricular septal defect, with direct or
patch closure
Repair of incomplete or partial atrioventricular canal (ostium primum
atrial septal defect), with or without atrioventricular valve repair
Closure of aortico-left ventricular tunnel
Complete repair of anomalous venous return (supracardiac, intracardiac,
or infracardiac types)
Repair of cor triatriatum or supravalvular mitral ring by resection of left
atrial membrane
Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type
operation)
Atrial septectomy or septostomy; open heart with cardiopulmonary
bypass
Atrial septectomy or septostomy; open heart, with inflow occlusion
Repair of transposition of the great arteries, atrial baffle procedure (eg,
Mustard or Senning type) with cardiopulmonary bypass;
Repair of transposition of the great arteries, atrial baffle procedure (eg,
Mustard or Senning type) with cardiopulmonary bypass; with removal
of pulmonary band
Repair of transposition of the great arteries, atrial baffle procedure (eg,
Mustard or Senning type) with cardiopulmonary bypass; with closure of
ventricular septal defect
Repair of transposition of the great arteries, atrial baffle procedure (eg,
Mustard or Senning type) with cardiopulmonary bypass; with repair of
subpulmonic obstruction
Repair of transposition of the great arteries, aortic pulmonary artery
reconstruction (eg, Jatene type);
33619
33641
33647
33660
33722
33730
33732
33735
33736
33737
33774
33775
33776
33777
33778
Repair of transposition of the great arteries, aortic pulmonary artery
reconstruction (eg, Jatene type); with removal of pulmonary band
33779
Repair of transposition of the great arteries, aortic pulmonary artery
reconstruction (eg, Jatene type); with closure of ventricular septal defect
33780
Repair of transposition of the great arteries, aortic pulmonary artery
reconstruction (eg, Jatene type); with repair of subpulmonic obstruction
Aortic suspension (aortopexy) for tracheal decompression (eg, for
tracheomalacia) (separate procedure)
Repair of hypoplastic or interrupted aortic arch using autogenous or
prosthetic material; without cardiopulmonary bypass
Repair of hypoplastic or interrupted aortic arch using autogenous or
prosthetic material; with cardiopulmonary bypass
33781
33800
33852
33853
Page 5 of 10
Ascending aorta graft, with cardiopulmonary bypass, with or without
valve suspension; with aortic root replacement using composite
prosthesis and coronary reconstruction
Ascending aorta graft, with cardiopulmonary bypass with valve
suspension, with coronary reconstruction and valve-sparing aortic
annulus remodeling (eg, David Procedure, Yacoub Procedure)
Repair of thoracoabdominal aortic aneurysm with graft, with or without
cardiopulmonary bypass
Bypass graft, with other than vein, transcervical retropharyngeal carotidcarotid, performed in conjunction with endovascular repair of
descending thoracic aorta, by neck incision
Insertion of intra-aortic balloon assist device, percutaneous
Removal of intra-aortic balloon assist device, percutaneous
Insertion of intra-aortic balloon assist device through the femoral artery,
open approach
Removal of intra-aortic balloon assist device including repair of femoral
artery, with or without graft
Insertion of intra-aortic balloon assist device through the ascending
aorta
Removal of intra-aortic balloon assist device from the ascending aorta,
including repair of the ascending aorta, with or without graft
Unlisted procedure, cardiac surgery
Open repair of infrarenal aortic aneurysm or dissection, plus repair of
associated arterial trauma, following unsuccessful endovascular repair;
tube prosthesis
Open repair of infrarenal aortic aneurysm or dissection, plus repair of
associated arterial trauma, following unsuccessful endovascular repair;
aorto-bi-iliac prosthesis
Open repair of infrarenal aortic aneurysm or dissection, plus repair of
associated arterial trauma, following unsuccessful endovascular repair;
aorto-bifemoral prosthesis
Open iliac artery exposure with creation of conduit for delivery of
infrarenal aortic or iliac endovascular prosthesis, by abdominal or
retroperitoneal incision, unilateral
Open brachial artery exposure to assist in the deployment of infrarenal
aortic or iliac endovascular prosthesis by arm incision, unilateral
Transluminal balloon angioplasty, open; aortic
Transluminal peripheral atherectomy, open; aortic
Transluminal peripheral atherectomy, percutaneous; aortic
Bypass graft, with vein; carotid
Bypass graft, with vein; carotid-subclavian
Bypass graft, with vein; subclavian-carotid
Bypass graft, with vein; carotid-vertebral
33863
33864
33877
33891
33967
33968
33970
33971
33973
33974
33999
34830
34831
34832
34833
34834
35452
35481
35491
35501
35506
35507
35508
Page 6 of 10
Bypass graft, with vein; carotid-carotid
Bypass graft, with vein; carotid-brachial
Bypass graft, with vein; subclavian-subclavian
Bypass graft, with vein; subclavian-brachial
Bypass graft, with vein; subclavian-vertebral
Bypass graft, with vein; subclavian-axillary
Bypass graft, with vein; axillary-axillary
Bypass graft, with vein; axillary-femoral
Bypass graft, with vein; axillary-brachial
Bypass graft, with vein; brachial-ulnar or -radial
Bypass graft, with vein; brachial-brachial
Bypass graft, with vein; aortosubclavian or carotid
Bypass graft, with vein; aortoceliac or aortomesenteric
Bypass graft, with vein; axillary-femoral-femoral
Bypass graft, with vein; splenorenal
Bypass graft, with vein; aortoiliac
Bypass graft, with vein; aortobi-iliac
Bypass graft, with vein; aortofemoral
Bypass graft, with vein; aortobifemoral
Bypass graft, with vein; aortoiliofemoral, unilateral
Bypass graft, with vein; aortoiliofemoral, bilateral
Bypass graft, with vein; aortofemoral-popliteal
Bypass graft, with vein; femoral-popliteal
Bypass graft, with vein; femoral-femoral
Bypass graft, with vein; aortorenal
Bypass graft, with vein; ilioiliac
Bypass graft, with vein; iliofemoral
Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal
artery or other distal vessels
Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal
vessels
Harvest of femoropopliteal vein, one segment, for vascular
reconstruction procedure (eg, aortic, vena caval, coronary, peripheral
artery) (List separately in addition to code for primary procedure)
Bypass graft, with other than vein; carotid
Bypass graft, with other than vein; carotid-subclavian
Bypass graft, with other than vein; subclavian-subclavian
Bypass graft, with other than vein; subclavian-axillary
Bypass graft, with other than vein; axillary-femoral
Bypass graft, with other than vein; axillary-popliteal or -tibial
35509
35510
35511
35512
35515
35516
35518
35521
35522
35523
35525
35526
35531
35533
35536
35537
35538
35539
35540
35548
35549
35551
35556
35558
35560
35563
35565
35566
35571
35572
35601
35606
35612
35616
35621
35623
Page 7 of 10
Bypass graft, with other than vein; aortosubclavian or carotid
Bypass graft, with other than vein; aortoceliac, aortomesenteric,
aortorenal
Bypass graft, with other than vein; splenorenal (splenic to renal arterial
anastomosis)
Bypass graft, with other than vein; aortoiliac
Bypass graft, with other than vein; aortobi-iliac
Bypass graft, with other than vein; carotid-vertebral
Bypass graft, with other than vein; subclavian-vertebral
Bypass graft, with other than vein; aortobifemoral
Bypass graft, with other than vein; aortofemoral
Bypass graft, with other than vein; axillary-axillary
Bypass graft, with other than vein; aortofemoral-popliteal
Bypass graft, with other than vein; axillary-femoral-femoral
Bypass graft, with other than vein; femoral-popliteal
Bypass graft, with other than vein; femoral-femoral
Bypass graft, with other than vein; ilioiliac
Bypass graft, with other than vein; iliofemoral
Bypass graft, with other than vein; femoral-anterior tibial, posterior
tibial, or peroneal artery
Bypass graft, with other than vein; popliteal-tibial or -peroneal artery
Bypass graft; composite, prosthetic and vein (List separately in addition
to code for primary procedure)
Bypass graft; autogenous composite, two segments of veins from two
locations (List separately in addition to code for primary procedure)
Bypass graft; autogenous composite, three or more segments of vein
from two or more locations (List separately in addition to code for
primary procedure)
Placement of vein patch or cuff at distal anastomosis of bypass graft,
synthetic conduit (List separately in addition to code for primary
procedure)
Reimplantation, visceral artery to infrarenal aortic prosthesis, each
artery (List separately in addition to code for primary procedure)
Limited lymphadenectomy for staging (separate procedure); pelvic and
para-aortic
Limited lymphadenectomy for staging (separate procedure);
retroperitoneal (aortic and/or splenic)
Ventricular puncture through previous burr hole, fontanelle, suture, or
implanted ventricular catheter/reservoir; without injection
Ventricular puncture through previous burr hole, fontanelle, suture, or
implanted ventricular catheter/reservoir; with injection of medication or
other substance for diagnosis or treatment
35626
35631
35636
35637
35638
35642
35645
35646
35647
35650
35651
35654
35656
35661
35663
35665
35666
35671
35681
35682
35683
35685
35697
38562
38564
61020
61026
Page 8 of 10
Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular
62190
Creation of shunt; ventriculo-atrial, -jugular, -auricular
62220
Level IV - Surgical pathology, gross and microscopic examination
Abortion - Spontaneous/Missed Artery, Biopsy Bone Marrow, Biopsy
Bone Exostosis Brain/Meninges, Other than for Tumor Resection
Breast, Biopsy, Not Requiring Microscopic Evaluation of Surgical
Margins Breast, Reduction Mammoplasty Bronchus, Biopsy Cell Block,
Any Source Cervix, Biopsy Colon, Biopsy Duodenum, Biopsy
Endocervix, Curettings/Biopsy Endometrium, Curettings/Biopsy
Esophagus, Biopsy Extremity, Amputation, Traumatic Fallopian Tube,
Biopsy Fallopian Tube, Ectopic Pregnancy Femoral Head, Fracture
Fingers/Toes, Amputation, Non-traumatic Gingiva/Oral Mucosa, Biopsy
Heart Valve Joint, Resection Kidney, Biopsy Larynx, Biopsy
Leiomyoma(s), Uterine Myomectomy - without Uterus Lip,
Biopsy/Wedge Resection Lung, Transbronchial B
88305
Placement of visceral extension prosthesis for endovascular repair of
abdominal aortic aneurysm involving visceral vessels, each visceral
branch, radiological supervision and interpretation (List separately in
addition to code for primary procedure)
0081T
Internal mammary artery graft performed for primary, isolated coronary
artery bypass graft procedure (CABG)
4110F
Case ICD 9 codes (any of the below)
Description
Percutaneous angioplasty or atherectomy of precerebral (extracranial)
vessel(s)
Percutaneous angioplasty or atherectomy of intracranial vessel(s)
Percutaneous transluminal coronary angioplasty [PTCA] or coronary
atherectomy
Closed heart valvotomy, aortic valve
Other replacement of aortic valve
Open heart valvuloplasty of aortic valve without replacement
Single internal mammary-coronary artery bypass
Repair of atrial and ventricular septa with prosthesis
Repair of atrial and ventricular septa with tissue graft
Other and unspecified repair of atrial and ventricular septa
Total repair of certain congenital cardiac anomalies
Repair of ventricular septal defect with tissue graft
Other and unspecified repair of ventricular septal defect
Bypass anastomosis for heart revascularization
Aortocoronary bypass for heart revascularization, not otherwise
specified
Open chest coronary artery angioplasty
Double internal mammary-coronary artery bypass
Other bypass anastomosis for heart revascularization
ICD 9 Code
00.61
00.62
00.66
35.01
35.22
35.11
35.15
35.5
35.6
35.7
35.8
35.62
35.72
36.1
36.10
36.03
36.16
36.19
Page 9 of 10
Other shunt or vascular bypass
Aorta-renal bypass
Aorta-iliac-femoral bypass
Other (peripheral) vascular shunt or bypass
Angioplasty or atherectomy of other non-coronary vessel(s)
Percutaneous cardiopulmonary bypass
Postsurgical aortocoronary bypass status
Percutaneous transluminal coronary angioplasty, postsurgical status
Mechanical complication due to coronary bypass graft
39.23
39.24
39.25
39.29
39.50
39.66
V45.81
V45.82
996.03
Case CPT codes = heart transplant (any of the below)
Description
Anesthesia for heart transplant or heart/lung transplant
Heart-lung transplant with recipient cardiectomy-pneumonectomy
Heart transplant, with or without recipient cardiectomy
ICD-9 Code
580
33935
33945
Case Possible ICD 9 codes (any of the below)
Description
Atrial Fibrillation
ICD-9 Code
427.31
Control ICD 9 codes (any of the below)
Description
Atrial Fibrillation
ICD-9 Code
427.31
Atrial Fibrillation & Flutter
Atrial Flutter
427.3
427.32
Page 10 of 10