A pacemaker is a small device containing a pulse generator and leads. It is placed under the skin in the chest with leads threaded through veins into the heart to help control abnormal heart rhythms (arrhythmias) using electrical pulses to prompt the heart to beat at a normal rate.  Patients with a slow heart are said to have bradycardia. Pacemakers are implanted in patients with bradycardia to stimulate the heart to beat at a normal rate and pump more effectively. Bradycardia occurs when the electrical signal from the sinus atrial (SA) node slow or disappear and do not produce enough beats. Bradycardia may also occur when the patient has AV block when not all heartbeats are able to travel from the top chamber to the bottom chamber of the heart.

An Implantable cardioverter-defibrillator (ICD) detects and stops abnormal heartbeats or arrhythmias.The ICD continuously monitors the heartbeat and delivers electrical pulses or high energy shock to restore a normal heart rhythm when necessary. ICDs prevent sudden death in ventricular tachycardia or fibrillation patients. Ventricular tachycardia occurs when the bottom chambers of the heart (the ventricles) beat too fast and have a hard time pumping blood. Ventricular fibrillation occurs when the ventricles beat too fast and unevenly making the heart flutter resulting in little or no blood pumped to the body and brain.

Cardiac Electrophysiology procedures analyze, diagnose and treat the heart’s electrical activities. The treatments identify where an arrhythmia or abnormal rhythm is originating. Each heartbeat is triggered by an electrical impulse normally generated from special cells in the atrium (upper right chamber of the heart). When a person has atrial fibrillation, these signals are faulty, firing so rapidly that the upper chambers of your heart quiver (fibrillate) instead of beating efficiently.

Electrophysiology procedures take place in an electrophysiology (EP) Lab or a catheterization (Cath) lab at a hospital while the patient is mildly sedated. The EP mapping procedure is used to determine the appropriate therapy a patient needs; including medication, device implantation, cardiac ablation/cryotherapy, or cardiovascular surgery.

During an Electrophysiology (EP) study three to five electrically sensitive catheters are placed inside the heart to record electrical activity.  An EP study, typically lasts from two to four hours. Additional time is spent if treatments such as cardiac ablation or cryotherapy are used. An EP mapping procedure in total may last three to six hours.

EP Ablation Procedures take place after the EP mapping study has identified the areas of electrical abnormality needing treatment. The doctor threads long ablation catheters through blood vessels to your heart. Ablation catheters using extreme heat or cold are used to disrupt or eliminate cardiac arrhythmias, or abnormal heart rhythms by disabling those cells that cause AF or Atrial Fibrillation, thus restoring the heart to a normal rhythm.

The most common EP technique for treating atrial fibrillation is a catheter ablation procedure using heat. The use of cryoablation or extreme cold is a newer technique. The doctor runs a catheter from the groin to the area of the heart where the arrhythmia originates. He or she then uses it to deploy and inflate a tiny balloon that freezes the area. The result in both hot or cold ablation procedures is scar tissue that stops the firing pathway of the faulty signals.

Structural heart disease is one of the fastest growing segments of cardiovascular therapies. Structural heart disease refers to defects in the heart’s valve, walls or chambers and can be congenital (present at birth) or develop with age. Atrial septal defect (ASD) is a structural defect is congenital and present at birth. Aortic stenosis and mitral valve prolapse are structural heart conditions that occur over time with age. Open-heart surgery may still be required for some structural heart disease, but new catheter-based percutaneous (through the skin) therapies provide the benefits of lower risk, faster recovery and shorter hospitalization.

Structural heart procedures are performed by passing instruments through catheters inserted through the leg into the heart to deliver treatment devices. For example, a patient with a diseased heart valve may receive a new valve inserted via catheter in a compressed state which is then expanded once in the correct position, where it becomes a fully functioning valve.

Common structural heart procedures include valve replacements, repairs, clips, closures. Therapies include Transcatheter Aortic Valve Replacement (TAVR), Transcatheter Mitral Valve Repair (TMVR), Atrial and Ventricular Septal Defects (ASD/VSD), Hypertrophic Cardiomyopathy (HOCM), Left Atrial Appendage Occlusion, Paravalvular Leak Repair, and Pulmonary Embolism.

Interventional cardiology treatments include cardiac catheterization, balloon angioplasty, and stent implantation.

A Cardiac Catheterization is a diagnostic test used to evaluate the presence, size, and location of plaque deposits in the arteries, the strength of the heart muscle, and the function of the heart valves. During cardiac catheterization, a catheter is inserted into a blood vessel in the leg or wrist and gently guided toward the heart. Contrast dye is injected into the arteries of the heart so that the cardiologist can trace the movement of blood through the arteries and the chambers of the heart.

Angioplasty which is also called Percutaneous Coronary Intervention is used to restore blood flow to the heart. This procedure is done as an emergency procedure for a heart attack patient or a scheduled procedure to treat the condition of chronically inadequate blood flow to the heart.

Balloon angioplasty uses a catheter with a balloon tip which is inserted into the site of the blocked artery and then inflated to stretch open the walls of the artery. An Atherectomy procedure uses a catheter with a special pulverizing device to open hardened blockages in the coronary arteries.  A cardiac stent is a small metal coil which permanently holds a clogged vein open. Stenting and atherectomy procedures are often done in conjunction with angioplasty.