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Diagnostic and surgical procedures undertaken in the daycase/in-patient theatre include:
Coronary angiography (catheterisation)
This is when a thin, flexible tube called a catheter, is threaded through an artery in your arm or groin which leads to the heart. A special dye that shows up on X-Ray pictures is injected into the tube and X-Ray pictures are taken. This examination, which is performed under a local anaesthetic, helps to find out if your coronary arteries are blocked and how well your heart valves are working. This procedure is performed under local anaesthetic.
Coronary angioplasty is when a catheter is threaded towards your heart using X-Ray images to direct the catheter toward the narrowed section of the artery. The angioplasty catheter has a tiny balloon on its shaft; this balloon is gently inflated to open up your heart arteries. The balloon is deflated after a couple of minutes and removed, leaving more room in the artery for blood to flow to your heart. Occasionally a small wire metal mesh (a stent) can be inserted at the same time as the angioplasty, creating a scaffold to hold the artery open to improve blood flow and reduce symptoms. Your consultant will advise whether a stent is suitable in your case.
A pacemaker is a small device with one or more leads. It is inserted under local anaesthetic under the skin, just below the collar bone and the leads are placed into the heart through a vein. The pacemaker sends electrical impulses to the heart to help it produce a heart beat.
Cardioversion is a treatment to restore the heart back to its normal rhythm. The most common type of arrhythmia is called atrial fibrillation. This means that the upper chambers in your heart are moving fast and aren’t contracting properly. The symptoms include dizziness, fainting, palpitations and a fluttering feeling in your chest. Cardioversion involves applying a controlled electric shock to your chest to reset your heart’s normal rhythm. Cardioversion is performed under a general anaesthetic or heavy sedation.
Ablation of arrhythmia
This is used to treat abnormal heart rhythms. A catheter is inserted into your heart and a machine directs energy towards your heart muscle which helps to regulate your heart beat.
Transoesophageal Echo (TOE)
A Transesophageal Echocardiogram (TOE) allows your consultant to undertake a graphic outline of the heart's movement, valves and chambers. During a TOE, an endoscopic probe is placed in the oesophagus via an endoscopic procedure; this provides pictures of the heart's valves and chambers and helps the consultant evaluate the pumping action of the heart.
Implantable cardioverter defibrillator
An implantable cardioverter defibrillator (ICD) is a small, slim, box-shaped device that looks similar to a pacemaker and is designed to detect life-threatening abnormal heart rhythms. Similar to a pacemaker, the defibrillator is implanted under the skin and is connected to the heart via a wire threaded through a vein. The device monitors your heart and if it detects a dangerously fast heart rhythm, it triggers an electric shock to your heart to restore normal rhythm.
Cardiac Resynchronisation Therapy (CRT)
CRT uses a specialised pacemaker (also called a biventricular pacemaker) that specifically aims to improve the coordination of the heart’s contraction in patients suffering with heart failure. A standard pacemaker paces the right ventricle only whilst the biventricular pacemaker used in cardiac resynchronisation therapy paces both the left and right ventricles to ensure that both ventricles beat simultaneously. It is implanted under the skin, usually just beneath the collarbone and the leads are placed into the heart through the veins.
Implantable Loop Recorders (ILR)
An ILR is a very small device that is implanted under the skin and records the heart beat over a long period of time until the device is explanted (usually up to 2 years). This device is particularly helpful for patients with intermittent symptoms. Regular downloads are performed in clinic.