{"id":9652,"date":"2021-12-28T17:56:52","date_gmt":"2021-12-28T15:56:52","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/"},"modified":"2022-01-19T14:55:12","modified_gmt":"2022-01-19T12:55:12","slug":"interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/","title":{"rendered":"Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Interventional cardiology is a subspeciality of cardiology, dealing with catheter-based treatment of heart diseases, such as coronary artery disease, valvular disease, and congenital heart disease.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Coronary angioplasty (PCI)<\/li><li>Coronary thrombectomy<\/li><li>Valvuloplasty\/valve repair\/valve replacement<\/li><li>Correction of congenital abnormalities<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">They can be done as a preventive procedure, or as an emergency, to treat acute MI and revascularize an occluded vessel.<\/p>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Coronary angioplasty and stent implantation<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">PCI is commonly used synonymously with coronary angioplasty; it is a procedure used for treating narrowed coronary vessels.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coronary angioplasty and stent implantation are minimally-invasive procedures involving the insertion of a catheter through the skin and the femoral\/radial\/brachial artery into the coronaries, visualization of the vasculature under fluoroscopy, and the inflation of a balloon, and\/or the placement of a stent in the site of occlusion.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Once the catheter is placed in the coronary artery, the vasculasture is visualized using a radio-opaque dye.<\/li><li>A guidewire is passed into the site of occlusion. The angioplasty catheter is pushed to the site of the guidewire, and the balloon is inflated, compressing the atherosclerotic plaque.<\/li><li>Balloon angioplasty is rarely done on its own. Typically, a stent is placed on the balloon, and once it inflates, the stent opens and helps keep the vessel open.<\/li><li>The stent may be coated with polymers or drugs (drug-eluting) or uncoated (bare-metal).<\/li><li>According to current research, the stent is useful for the first three months after the procedure.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Other procedures that could be done during PCI include atherectomy and brachytherapy.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Catheter ablation<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">Catheter ablation (cardiac ablation) is a minimally-invasive procedure done to ablate (destroy) areas of the heart which produce arrhythmias (such as in AF).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is done by inserting a catheter into a large vein (femoral) and reaching into the heart under fluoroscopy. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>An EP study along with cardiac mapping is being done, the arrhythmic sites are found, and cardiac ablation is performed.<\/li><li>Cardiac ablation may be done using RF (heat) or cryoablation (cold).<\/li><li>If the lesion is small, a <strong>focal ablation<\/strong> is done; however, if the lesion is large, <strong>ablation remodeling<\/strong> is done.<\/li><li>The left atrium can be reached using a <strong>transseptal puncture<\/strong>.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Types of catheter ablations include:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Atrial flutter ablation<\/li><li>Pulmomary vein isolation (for Afib)<\/li><li>AV node ablation (requires a pacemaker)<\/li><li>Ventricular tachycardia ablation<\/li><li>SVT ablation<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Pacemaker therapy<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">Pacemakers sense electrical events and respond when necessary by delivering electrical stimuli to the heart. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>It is a battery-operated device consisting It consists of a signal generator, and leads that connect to the heart.<\/li><li>The leads include a sensor inserted into a chamber, and a pacer, which delivers the stimulus.<\/li><li>Indicated for solving long-lasting, symptomatic rhythm disorders, mostly involving bradycardias (and less commonly, tachycardias), for example:<ul><li>Sinus node dysfunction<\/li><li>Advanced AV block (3rd degree\/Mobitz II)<\/li><li>Bundle branch blocks<\/li><li>Transplantation<\/li><\/ul><\/li><li>Their battery lasts for 7-8 years.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Types of pacemakers are designated by 3 to 5 letters:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>1st Letter: Chamber Paced<ul><li>A= Atrium<\/li><li>V= Ventricle<\/li><li>D= Dual (A+V)<\/li><\/ul><\/li><li>2nd Letter: Chamber Sensed<ul><li>A= Atrium<\/li><li>V= Ventricle<\/li><li>D= Dual (A+V)<\/li><li>O= None<\/li><\/ul><\/li><li>3rd Letter: Response after Sensing (i.e. Response to sensed beat)<ul><li>I = Pacing Inhibited<\/li><li>T= Pacing Triggered<\/li><li>D= Dual (I+T)<\/li><li>O= None<\/li><\/ul><\/li><li>4th Letter: Programmability (Program features)<ul><li>P = Rate &amp; Output<\/li><li>M = Multiprogramable<\/li><li>C = Communicating<\/li><li>R = Rate adaptive<\/li><li>O = None<\/li><\/ul><\/li><li>5th Letter: Arrhythmia Control<ul><li>P = pacing<\/li><li>S= shock<\/li><li>D= Dual (P+S)<\/li><li>O = NoneThe most common pacemakers are VVI and DDD.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Examples:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>VVI = ventricular pacing and sensing, inhibition<\/li><li>DDD = dual, dual, dual (both inhibits and triggers)<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rate-responsive pacemakers<\/strong> detect changes in the patient&#8217;s physical activity and adjust the pacing accordingly<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Complications <\/strong>of pacemakers generally include tachycardia, <strong>pacemaker syndrome<\/strong> (loss of synchrony between the atria and ventricles leading to worsening of the patient&#8217;s condition), and electrical interferences.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">ICDs<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">ICD = Implantable Cardioverter-Defibrillators<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">ICDs are essentially pacemakers with extra features. They can defibrillate the heart in response to ventricular tachycardia (VT) or ventricular fibrillation (VF). They do not prevent them, but rather end them; and they are used along with antiarrhythmic drugs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">They are implanted subcutaneously or subpectorally, with electrodes inserted into the right ventricle and sometimes also the right atrium.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">They last for 5-7 years.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">CRTs<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">CRT =Cardiac resynchronization therapy<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It uses a pacing system to resynchronize cardiac contraction. It is basically a biventricular pacemaker.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>For Patients with Heart Failure<\/li><li>Usually Equipped with ICD function (CRT-D) but it can be a pacemaker only without ICD (CRT-P)<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Coronary angioplasty and stent implantation<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Catheter ablation<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Pacemaker therapy<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">ICDs<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">CRTs<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Interventional cardiology is a subspeciality of cardiology, dealing with catheter-based treatment of heart diseases, such as coronary artery disease, valvular disease, and congenital heart disease. Coronary angioplasty (PCI) Coronary thrombectomy Valvuloplasty\/valve repair\/valve replacement Correction of congenital abnormalities They can be done as a preventive procedure, or as an emergency, to treat acute MI and revascularize [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":410,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9652","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy) &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\\\/\",\"name\":\"Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy) &#8211; Meddists\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\"},\"datePublished\":\"2021-12-28T15:56:52+00:00\",\"dateModified\":\"2022-01-19T12:55:12+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\\\/\\\/meddists.com\\\/learn\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Clinical\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Internal medicine\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Cardiology\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/cardiology\\\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/\",\"name\":\"Meddists\",\"description\":\"Let&#039;s Get Studying\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/meddists.com\\\/learn\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy) &#8211; Meddists","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/","twitter_misc":{"Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/","url":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/","name":"Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy) &#8211; Meddists","isPartOf":{"@id":"https:\/\/meddists.com\/learn\/#website"},"datePublished":"2021-12-28T15:56:52+00:00","dateModified":"2022-01-19T12:55:12+00:00","breadcrumb":{"@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/interventional-cardiology-coronary-angioplasty-and-stent-implantation-catheter-ablation-pacemaker-therapy\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/meddists.com\/learn\/"},{"@type":"ListItem","position":2,"name":"Clinical","item":"https:\/\/meddists.com\/learn\/clinical\/"},{"@type":"ListItem","position":3,"name":"Internal medicine","item":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/"},{"@type":"ListItem","position":4,"name":"Cardiology","item":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/cardiology\/"},{"@type":"ListItem","position":5,"name":"Interventional cardiology (coronary angioplasty and stent implantation, catheter ablation, pacemaker therapy)"}]},{"@type":"WebSite","@id":"https:\/\/meddists.com\/learn\/#website","url":"https:\/\/meddists.com\/learn\/","name":"Meddists","description":"Let&#039;s Get Studying","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/meddists.com\/learn\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9652","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/comments?post=9652"}],"version-history":[{"count":11,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9652\/revisions"}],"predecessor-version":[{"id":10168,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/9652\/revisions\/10168"}],"up":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/410"}],"wp:attachment":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/media?parent=9652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}