Cardiac Treatments
Electrophysiology
Simply put, electrophysiology is the study of the heart’s electrical conduction system. This is the “circuitry” that controls the rhythmic contractions of the heart, keeping blood pumping and circulating throughout the body.
An electrophysiology study (EP Study) is any procedure that consists of an electrode catheter being inserted into the heart. These catheters transmit electrical currents to and from the heart.
Using these electrode catheters and sophisticated computers, an EP study can generate electrocardiogram (EKG) tracings and electrical measurements, which are used to detect heart abnormalities. In addition, EP studies can be used in certain procedure such as pacemaker implantation and cardiac ablation.
Carto 3D Mapping
Carto is a mapping system that displays a 3-dimensional reconstruction of the heart chambers. This information can be used to detect origin of certain abnormal heart rhythms.
ICD Implants
An implantable cardioverter-defibrillator (ICD) is a minicomputer attached to the heart that monitors for abnormal heart rhythms and can correct them when they occur by administering a small electric shock to the heart muscle.
Pacemaker Implants
A small, electronic device inserted under the skin to help the heart beat regularly and at a proper pace.
Bi-Ventricular Pacemaker Implants
A type of implantable pacemaker that regulates both of the ventricles (the heart’s pumping chambers) together.
Cardiac Ablations
Ablation refers to the intentional destruction of heart tissue that is misfiring or “short circuiting” to correct the short circuit.
Carotid Stenting
Carotid artery stenting is a procedure in which a vascular surgeon inserts a slender, metal-mesh tube (a stent) into a carotid artery blocked by plaque buildup. The stent expands to increase blood flow through the artery.
Plaque typically builds up in the walls of your arteries as you age, causing the arteries to narrow and stiffen. This can lead to reduced blood flow, or cause blood clots or pieces of plaque to break away and block arteries in the brain, since the carotid arteries (located in the neck) carry blood directly to the brain.
Using a stent is an alternative to removing the plaque surgically. Essentially, the stent acts as a brace, or scaffolding, to hold the artery open and allow for unobstructed blood flow.
Carotid Diagnostic Testing
Testing, such as ultrasound tests, used to locate plaque buildups in the carotid arteries of the neck.
Atrial Fib Ablations
Atrial fib is the commonly used abbreviation for “atrial fibrillation”, which is the most common form of arrhythmia, or abnormal heart rhythm. Ablation is a form of treatment that selectively destroys very small parts of the heart that are causing the atrial fib.
Coronary Stenting
A coronary stent is an artificial support device used the keep the coronary artery open. A small, hollow cylinder made of a steel mesh; the stent expands inside the blood vessel to hold it open much like a brace or scaffolding.
The stenting procedure is normally used following a balloon angioplasty to treat coronary artery disease, in which the arteries harden and narrow, restricting blood flow.
Bare Metal Stents
The standard stent, it is designed to conform to the shape of the wall of the artery in order to hold the wall to its fully opened position. For maximum durability and flexibility, bare metal stents are commonly constructed of materials such as stainless steel and cobalt chromium, and come in various sizes.
Drug Eluting Stents
Also known as a coated or medicated stent, a drug eluting stent is a normal metal stent that has been coated with a drug to prevent reblockage or the artery (restenosis). Sometimes the drug is imbedded in a thin polymer to allow for a time-release effect.
Peripheral Stenting
A procedure used to treat peripheral artery disease, which is the buildup of fatty deposits and plaque that block the flow of blood through arteries in the lower extremities. The most common symptom is pain in the legs and cramping when walking.
Stenting is a much less-invasive alternative to traditional bypass surgery. A small, metal-mesh tube is inserted via a catheter in the groin area, requiring only a tiny incision. The stent is then guided to the proper place and expanded to hold the blocked artery in an open position to allow proper blood flow and circulation.
Rotoblator (Atherectomy)
Athrectomy is a procedure that relieves symptoms of coronary artery disease by improving blood flow to your heart. During athrectomy, a catheter (a thin, soft, flexible tube) carrying a special cutting or grinding device clears the blockage.
PFO and VSD Closures
These are holes in the heart’s walls. Patent Foramen Ovales (PFOs) are tiny holes in the wall of muscles separating the upper chambers of the heart. These defects are estimated to be present in one out of every 10 American adults, and are the most prevalent cause of strokes in those under the age of 35. A PFO results from incomplete closure of the upper septum (the wall of muscle separating the two sides of the heart) shortly after birth, and frequently does undiagnosed until later in life.
To close a PFO, specialist implants in the heart a device that resembles two miniature umbrellas. Attached to a catheter and advanced to the heart, the flexible arms of the double-umbrella device open toward each other and then attach to either side of the defective heart wall, sealing the hole.
A very similar procedure is used to repair Ventricular Septal Defects (VSDs), which are ruptures of the lower septum. The same type of double-umbrella device is introduced into the heart by a catheter, inserted through a needle hole in the patient’s neck. The flaps of the umbrella deploy on either side of the breached septum and seal the hole.
Triple A Repairs
Triple A stands for abdominal aortic aneurysm, a potentially fatal condition. Recent advancements have allowed the AAA to be repaired from within the artery itself, avoiding a major abdominal incision.
Right and Left Heart Caths
These are procedures performed in a cath lab, short for catheter laboratory. Catheterization is a specialized study of the heart during which a catheter or thin hollow flexible tube is inserted into the artery of the groin or arm. Under x-ray visualization, the tip of the catheter is guided to the heart. A iodine dye is injected into the artery so that a visual representation of the blood vessels can be made.
If catheters are introduced through the femoral or groin artery, the procedure is known as left heart catheterization, and account for the majority of such procedures. If a catheter is also placed in the right femoral vein to measure pressures within the right side of the heart, the procedure is called "right heart" catheterization.
The right heart cath is used to measure pressures inside the heart chambers. The left heart cath also measure pressures, but also looks at the coronary arteries and the pumping ability of the heart.
SilverHawk (Peripheral Atherectomy Device)
The SilverHawkTM Plaque Excision System from FoxHollow Technologies is a revolutionary device for clearing plaque from arteries in the legs and other body extremities. It is used to alleviate impaired circulation in patients suffering from peripheral artery disease, which afflicts an estimated 12 million Americans.
The minimally invasive procedure employing SilverHawk is performed through a small puncture in the leg. The system used a tiny rotating blade to shave away plaque from inside the targeted artery. The plaque collects in the tip of the device and is then removed from the patient.
The SilverHawk procedure can be done under local anesthesia, and is a far less invasive option than standard bypass surgery, which requires general anesthesia and a 2-3 hospitalization.
Radiofrequency Catheter Ablations
Radiofrequency catheter ablation (RFCA) has revolutionized treatment for abnormally rapid heartbeats by replacing antiarrythmic drugs therapies.
Ablation means removal. In this case, radio frequency (RF) energy is used to inactivate some of the abnormal conduction pathways in the heart that are causing the abnormal heartbeats. Delivered through a catheter, the RF energy burns ("ablates") a portion of the abnormal electrical conduction pathways to provide a more consistent flow of electrical impulses.
Cardioversions
In a cardioversion, the patient is sedated, and a very brief current of electricity is administered to the chest to stop an irregular heartbeat and replace it with a normal rhythm.
Distal Embolic Protection
Various devices used to prevent arterial complications such as distal embolisms, which are broken off pieces of plaque that travel down the arteries and become lodged, clogging a blood vessel.
Filter Wire
A tiny basket fitted at the tip of a catheter that traps plaque and tiny blood clots that become dislodged during bypass angioplasty procedures.
Tilt Table Studies
A test used to evaluate patients who have had problems with loss of consciousness. As the name suggests, the study uses a tilting table to diagnose blood pressure and other circulatory issues.
Greenfield Filters
A filter placed in the inferior vena cava (the large vein that returns blood to the heart) to trap clots and prevent pulmonary embolisms (blood clots in the lungs).
Special Equipment ICE - Intracardiac Echo or Intravascular Echo
A diagnostic imaging system used to paint a picture of the cardiac (heart and blood vessels) environment.
IVUS - Intravascular Ultrasound
A catheter based technique that provides real-time, high-resolution images of a blood vessel.
Angiojet
A device that shoots jets of high-speed saline solution through tiny opening in the tip of a catheter to dissolve clots and plaque, which are then vacuumed back through the catheter.