Dr Charan Reddy – Interventional Cardiologist

A diagnostic procedure using X-ray imaging to visualize the heart's blood vessels for blockages or abnormalities.

Coronary Angioplasty, also known as Percutaneous Coronary Intervention (PCI), is a minimally invasive procedure used to open blocked or narrowed coronary arteries that supply blood to the heart. Reduced blood flow to the heart can cause chest pain (angina) and may lead to a heart attack. Angioplasty restores normal blood flow and helps protect the heart from further damage.

When Is Coronary Angioplasty Needed?

• Persistent or severe chest pain (angina)

• Shortness of breath due to heart blockage

• During or after a heart attack

• Significant artery blockage found on coronary angiography

• When medications alone are not effective

  How Is Coronary Angioplasty Performed?

• A thin catheter is inserted through an artery in the wrist or groin

• The catheter is guided to the blocked coronary artery

• A small balloon is inflated to widen the artery

• In most cases, a stent is placed to keep the artery open

Coronary Catheterization is a diagnostic heart procedure used to examine how well the heart is functioning and to detect blockages or abnormalities in the coronary arteries. It helps cardiologists accurately assess blood flow to the heart and plan the most effective treatment. This procedure is often performed as part of cardiac catheterization and may lead to further treatment such as angioplasty or stent placement if required.
 

Why Is Coronary Catheterization Done?

Coronary catheterization is recommended to:

• Diagnose coronary artery disease (CAD)

• Evaluate chest pain or unexplained shortness of breath

• Assess heart valve or heart muscle function

• Check blood flow after a heart attack

• Guide treatment decisions before angioplasty or bypass surgery
   

  How Is Coronary Catheterization Performed?

• A thin, flexible tube (catheter) is inserted through an artery in the wrist or groin

• The catheter is carefully guided to the heart

• A contrast dye is injected to make coronary arteries visible on X-ray

• Images are taken to identify blockages, narrowing, or abnormalities

Pacemaker implantation is a medical procedure used to treat abnormal heart rhythms (arrhythmias). A pacemaker is a small electronic device placed under the skin that helps regulate the heart’s electrical activity and maintain a normal heartbeat when the heart beats too slowly, irregularly, or pauses unexpectedly.

Who Needs a Pacemaker?

Pacemaker implantation may be recommended if you experience:

• Slow heart rate (bradycardia)

• Fainting or dizziness due to irregular heartbeat

• Heart block or electrical conduction disorders

• Fatigue or shortness of breath caused by rhythm problems

• Certain cases of heart failure (advanced pacemakers)
   

  How Is Pacemaker Implantation Performed?

• The procedure is done under local anesthesia

• A small incision is made below the collarbone

• Leads (wires) are guided through a vein into the heart

• The pacemaker device is connected to the leads and placed under the skin

• The device is tested to ensure proper functioning

A Cardiac Resynchronization Therapy Defibrillator (CRT-D) is an advanced cardiac device used to treat heart failure and life-threatening abnormal heart rhythms. It combines the functions of a biventricular pacemaker and an implantable cardioverter defibrillator (ICD).

CRT-D helps the heart’s chambers beat in a coordinated manner while also delivering a life-saving shock if a dangerous rhythm is detected.
 

Who Needs a CRT-D?

CRT-D may be recommended for patients with:

• Moderate to severe heart failure

• Reduced left ventricular ejection fraction (LVEF)

• Electrical conduction delay (such as left bundle branch block)

• Symptoms like fatigue, shortness of breath, or swelling

• High risk of sudden cardiac arrest due to ventricular arrhythmias

  How Does CRT-D Work?

• Resynchronization Therapy: Coordinates the contractions of the right and left ventricles, improving the heart’s pumping efficiency

• Defibrillation: Detects dangerous heart rhythms and delivers an electrical shock to restore a normal rhythm

• Pacing Support: Prevents slow heart rates and rhythm irregularities

An Automatic Implantable Cardioverter Defibrillator (AICD) is a small electronic device implanted in the chest to monitor heart rhythm continuously and treat life-threatening abnormal heartbeats. If a dangerous rhythm such as ventricular tachycardia or ventricular fibrillation occurs, the AICD automatically delivers an electrical shock to restore a normal heartbeat.

Who Needs an AICD?

An AICD may be recommended for patients who:

• Are at high risk of sudden cardiac arrest

• Have a history of ventricular arrhythmias

• Have survived a previous cardiac arrest

• Have severe heart muscle weakness (low ejection fraction)

• Have certain inherited or structural heart conditions

  How Does an AICD Work?

• Continuous Monitoring: Tracks heart rhythm 24/7

• Anti-Tachycardia Pacing (ATP): Corrects fast rhythms without shock when possible

• Defibrillation Shock: Delivers a life-saving shock if a dangerous rhythm is detected

• Pacing Support: Prevents slow heart rates when needed

An Electrophysiology Study (EPS) is a specialized cardiac test used to evaluate the electrical activity of the heart. It helps doctors identify abnormal heart rhythms (arrhythmias) and determine their exact origin within the heart.

Why is EPS done?

EPS is recommended to:

• Diagnose fast or irregular heartbeats

• Identify the cause of palpitations, dizziness, or fainting

• Assess risk of sudden cardiac arrest

• Decide the need for ablation, pacemaker, or ICD

• Evaluate effectiveness of anti-arrhythmic medications

How is EPS performed?

• Thin flexible wires (catheters) are inserted through a vein (usually in the groin)

• Catheters are guided to the heart under X-ray imaging

• Electrical signals of the heart are recorded and analyzed

• Abnormal rhythm pathways are precisely located

Is EPS safe?

Yes. EPS is a minimally invasive and safe procedure, performed by experienced electrophysiologists in a controlled cardiac catheterization lab.

Radiofrequency Ablation (RFA)

Radiofrequency Ablation (RFA) is a minimally invasive treatment used to cure abnormal heart rhythms by destroying the tiny area of heart tissue responsible for the arrhythmia.

When is RFA recommended?

RFA is commonly used to treat:

• Supraventricular Tachycardia (SVT)

• Atrial Flutter

• Atrial Fibrillation (AF)

• Ventricular Tachycardia (VT)

• Wolff-Parkinson-White (WPW) syndrome

How does RFA work?

• After locating the abnormal pathway during EPS

• Controlled radiofrequency energy (heat) is delivered

• The faulty electrical tissue is destroyed

• Normal heart rhythm is restored permanently

Benefits of RFA

• High success rate (90–98% for many arrhythmias)

• No open surgery required

• Short hospital stay

• Long-term relief from arrhythmias

• Reduced need for lifelong medications

TAVI (Transcatheter Aortic Valve Implantation), TAVR (Transcatheter Aortic Valve Replacement), and TMVR (Transcatheter Mitral Valve Replacement) are advanced, minimally invasive procedures used to replace damaged heart valves without open-heart surgery.

These procedures are especially beneficial for patients who are high-risk or unsuitable for conventional surgery.

TAVI / TAVR (Aortic Valve Replacement)

What Is TAVI / TAVR?

TAVI (also called TAVR) is a procedure to replace a narrowed or leaking aortic valve using a catheter-based approach. A new valve is delivered through a blood vessel (usually via the leg) and placed inside the diseased valve.

Who Needs TAVI / TAVR?

• Severe aortic stenosis

• Elderly patients

• High or intermediate surgical risk patients

• Symptoms like chest pain, breathlessness, or fainting

TMVR (Transcatheter Mitral Valve Replacement)

What Is TMVR?

TMVR is a catheter-based procedure used to replace a damaged mitral valve without open-heart surgery. It improves blood flow between the left atrium and left ventricle, reducing heart failure symptoms.

Who Needs TMVR?

• Severe mitral valve disease

• Patients not suitable for surgical valve replacement

• Persistent breathlessness or heart failure symptoms

• Previous valve surgery or high surgical risk

A Leadless Pacemaker is a next-generation cardiac pacing device that helps regulate abnormal heart rhythms without the use of traditional wires (leads) or a surgical pocket under the skin. The device is extremely small—about the size of a large capsule—and is implanted directly inside the heart through a minimally invasive procedure.

Who Needs a Leadless Pacemaker?

A leadless pacemaker may be recommended for patients who:

• Have a slow heart rate (bradycardia)

• Require single-chamber ventricular pacing

• Have high risk of infection from traditional pacemakers

• Have limited or blocked veins

• Prefer a minimally invasive pacing option

How Is a Leadless Pacemaker Implanted?

1. The procedure is performed under local anesthesia

2. The device is delivered through a catheter inserted via a vein in the leg

3. The pacemaker is positioned directly inside the right ventricle

4. The device is secured and tested for proper function

The procedure typically takes less than 1 hour.

Benefits of a Leadless Pacemaker

• No leads or chest incision

• Lower risk of infection

• No visible device or scarring

• Faster recovery and minimal discomfort

• Improved patient comfort and mobility

MitraClip is a minimally invasive, catheter-based procedure used to treat mitral valve regurgitation (leakage of the mitral valve) without open-heart surgery. The MitraClip device clips together a portion of the mitral valve leaflets, allowing the valve to close more effectively and reducing backward blood flow.

This procedure is ideal for patients who are high-risk or not suitable for conventional heart surgery.

Who Needs MitraClip?

MitraClip may be recommended for patients with:

• Moderate to severe mitral valve regurgitation

• Symptoms such as breathlessness, fatigue, or heart failure

• High surgical risk due to age or other medical conditions

• Reduced heart function

• Failed or unsuitable for surgical valve repair

  How Is the MitraClip Procedure Performed?

• The procedure is done under general anesthesia

• A catheter is inserted through a vein in the leg

• The procedure typically takes 2–3 hours.

• The MitraClip device is guided to the mitral valve

• The valve leaflets are clipped together to reduce leakage

• Immediate improvement in blood flow is assessed