Cardiac Catheterization Lab
Cardiac catheterization lab, simply known as Cath lab, is where cardiologists perform diagnostic procedures (such as angiography and electrophysiology studies) and therapeutic interventions to treat many types of heart conditions.
Coronary Angiography is the Gold Standard test to diagnose Coronary Artery Disease. It is safe, effective, less time consuming and highly reliable. The procedure involves using a special dye (contrast) and x-rays to see how blood flows through the arteries in your heart.The procedure most often lasts 30 to 60 minutes. The same procedure is used to determine blockages in other vessels like renal artery (Kidney).
Electrophysiology Studies (EPS) Angioplasty (including PAMI)
Electrophysiology Studies (EPS) studies use cardiac catheterization techniques to study patients who have irregular heartbeats (called arrhythmias). EPS shows how the heart reacts to controlled electrical signals. These signals can help cardiologists find out where in the heart the arrhythmia starts and what medicines will work to stop it. EPS can also help doctors know what other catheter techniques could be used to stop the arrhythmia.
Angioplasty (including PAMI)
An angioplasty is a technique used to dilate a narrowed coronary artery with a balloon catheter. A small tube (catheter) is inserted in the groin which is then maneuvered into the heart and coronary arteries. A balloon is then inserted through the catheter. The balloon is inflated inside a blood vessel to flatten any plaque that blocks it and cause it to become narrowed, decreasing the blood flow. After the obstruction is relieved by the balloon dilation, most patients then immediately receive a stent. Stents are small, metal mesh cylinders that are delivered to the site of obstruction and expanded in the artery. Stents act as scaffolds to hold the artery open so it can heal with a normal diameter to allow blood to flow freely. Elective angioplasty is performed on patients who are not experiencing a heart attack, but have blockages significant enough to require an interventional procedure. Primary (or emergency) angioplasty (PAMI) is performed on a patient who is in the throes of an acute myocardial infarction (heart attack).
Sometimes, when the plaque (buildup of fat, cholesterol in artery's inner lining) is particularly hard, or so narrow that the balloon can’t pass through it during angioplasty, rotablation may be used. A special catheter (a thin tube) is inserted along the wire with a tiny drill at its tip. This drill is used to grind away the plaque to gradually widen the narrowing in the artery. Once this is done, a balloon can be inserted and the angioplasty proceeds as usual.
FFR Guided PCI
FFR (Fractional Flow Reserve) is a guide wire-based procedure that can accurately measure blood pressure and blood flow through a part of coronary artery. FFR is done through a standard diagnostic catheter at the time of coronary angiography. The measurement of Fractional Flow Reserve is useful in assessing whether or not to perform angioplasty on certain blockages.
CRT/ CRT-D (Cardiac Resynchronization Therapy)
There are two types of CRT devices. One is a special kind of pacemaker. It’s called a cardiac resynchronization therapy pacemaker (CRT-P) or “biventricular pacemaker.” The other is the same device, but it also includes a built-in implantable cardioverter defibrillator (ICD). This type is called a cardiac resynchronization therapy defibrillator (CRT-D).While functioning like a normal pacemaker to treat slow rhythms, CRT-P device also delivers small electrical impulses to the left and right ventricles to help them contract at the same time so you heart pumps more efficiently.A CRT-D is a special device for heart failure patients who are at high risk for sudden cardiac death. A CRT-D device can treat dangerously fast heart rhythms (arrhythmias) that can lead to sudden cardiac arrest. If the device senses heartbeats that are dangerously fast, it delivers a shock to the heart. This shock (defibrillation) stops the abnormal rhythm. Without this life-saving therapy, the dangerously rapid rhythm could lead to death in minutes.CRT devices are fitted with a battery which will run out over time. Since the battery is permanently placed inside device, it can’t be replaced when it’s down. So if the battery runs out, entire device needs to be replaced. The battery life depends on the settings your doctor programs and how much therapy you receive.
ICD & Pacemaker Implantation
Arrhythmias, which are abnormal heart rates or rhythms, are caused by issues with the electrical system of the heart. ICD (Implantable cardioverter-defibrillator) is a device that can correct these life-threatening arrhythmias. It can perform cardioversion, defibrillation, and pacing of the heart. It is implanted under the skin on the chest.
It can monitor and record the rate and rhythm of the heart. The main purpose of a pacemaker is to make sure the heart rate does not get too slow. It is implanted under the skin on the chest.
In this procedure, a thin catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed heart valve, a balloon located on the tip of the catheter is inflated, causing widening of the valve.
PDA, ASD, VSD Closures
PDA (Patent Ductus Arteriosus), ASD (Atrial Septal Defect) and VSD (Ventricular Septal Defect) are the congenital birth defects of the heart. All these defects allow blood to pass from the left side of the heart to the right side, which is abnormal and increase load on the heart. Majority of these defects can be corrected in cath lab without needing open heart surgery.
Electrophysiology studies are minimally invasive procedure used for diagnostic study which tests the electrical conduction system of the heart. It is recommended in people with heart rhythm problems (arrhythmias).