Hospital Services

Interventional Cardiology:

Cardiac Catheterization
Also referred to as a “coronary angiogram. This procedure evaluates the arteries of the heart for blockages or plaque buildup that impedes blood flow. It also measures pressure measurements and can evaluate heart function and valve function. It is performed in the hospital’s Cath Lab where catheters are inserted into the femoral artery in the leg or the radial artery in the wrist, and are used to track up to the heart where contrast dye is injected into the coronary arteries, and visualized by using real-time X-ray cameras. It is performed with local anesthesia and intravenous sedatives, and usually is not very painful and tolerated well.

Coronary Angioplasty/Stent Placement
Performed in the same way as a cardiac catheterization described above, this is a procedure by which a blockage in an artery supplying the heart can be opened up. This is done by the use of various catheters, wires, and small inflatable balloons that are delivered to the heart through tubes inserted into the artery of the leg or the wrist. A stent is a small metal tube that provides scaffolding to the area that is blocked to help restore blood flow. A stent usually requires one year of special blood thinners to help the stent heal.

Peripheral Angiogram/Angioplasty
A peripheral angiogram is a way to look for blockages in the arteries supplying the legs in people with peripheral arterial disease. This is usually done by inserting a small tube (like a large IV) into the artery of the leg, and injecting contrast dye and use X-ray imaging to get images of the blood vessels.
If a blockage is found, this can be fixed in the same manner using balloons to stretch out the vessel, devices to cut out the plaque, and/or stents that provide scaffolding for the diseased arteries to maintain blood flow down the legs.

Carotid Angiogram and Stent Placement
A procedure performed to evaluate the presence of blockages and plaque buildup in the carotid arteries in the neck that supply blood flow to the brain. Plaque buildup in this artery can lead to a stroke. Usually an ultrasound exam result will suggest a blockage that will lead to this test. If a severe blockage is found, it can be fixed by surgery, or in some cases, by inserting a stent into the artery to hold open the artery and cage off any plaque that may be at risk of causing strokes.

Renal Artery Stenting
A procedure to open up a blockage of the arteries that supply the kidneys (the renal arteries). This is done by using catheters, balloons, and stents similar to other peripheral angioplasty procedures. This is usually performed in situations when there are severe blockages of the renal arteries in patients with uncontrolled blood pressures.

Superior Mesenteric Artery Stenting
Mesenteric arteries are the blood vessels that supply blood to the intestines, particularly the superior mesenteric artery (SMA). In rare cases, there can be a severe blockage in the SMA that lead to significant pain and weight loss. If indicated, this can be fixed by inserting a stent to open up the blockage. This procedure is also done through catheters introduced into the arteries of the leg or the arm to access the mesenteric arteries.

TAVR
Transcatheter Aortic Valve replacement is a newer, minimally invasive procedure used to treat aortic valve stenosis. Currently approved for those very high risk for a traditional open operation, it allows us to replace the aortic valve without open heart surgery. The procedure is done with a special bovine bioprosthetic valve that is crimped on a catheter, which can be introduced into the body through large catheters inserted into the femoral artery from the groin, or directly into the heart from the chest wall via a small incision. This “stent valve” will be inflated inside the dysfunctional calcified aortic valve and can be done on the beating heart. Our structural heart specialists perform this procedure with the valve team at Baystate Medical Center. Click for more information.

Electrophysiology:

Pacemaker Implantation
A Pacemaker is usually required when there are problems with slow heart rates and abnormal heart rhythms, or other diseases affecting the electrical conduction of the heart. These can lead to symptoms such as dizziness, passing out, and weakness. It is performed under IV sedation and local anesthesia, and it involves a small incision usually in the upper left chest, through which the pacemaker is placed beneath the skin.

ICD Implantation
An Implantable Cardioverter Defibrillator, or ICD, is a device that is similar to a pacemaker but also carries the ability to deliver an electric shock to the heart in the event of a life-threatening rapid heart rhythm to “reset” the heart back to normal. It is indicated in specific patients with weak heart muscles that put them at risk for such heart rhythms. It is inserted just like a pacemaker, with a small incision on the top of the left chest, and is placed beneath the skin under local anesthesia and intravenous sedation.

Cardiac Resynchronization Therapy
This procedure is indicated for patients who have symptoms of heart failure and abnormal contraction of heart. These are special type of implantable pacemakers or defibrillators that have an extra lead implanted through a vein in the back of the heart. This extra lead will pace the left side of the heart to synchronize right and left side of the heart. This can lead to significant improvement in pumping capacity of heart and improvement of symptoms related to heart failure like shortness of breath, easy fatigability, swelling of legs and fullness in stomach.

EP Study
An Electrophysiology Study (or EP Study) is an electrical study of the heart from the inside. It aids in the diagnosis of problems involving the electrical conduction system of the heart, and for the evaluation of abnormal heart rhythms.
 It involves inserting catheters through the veins in the groin that track up into the heart under X-ray guidance where they take sensitive electrical recordings from the heart’s conduction system. Your doctor may order this test if you have signs of an abnormal heart rhythm. The results from this study helps your doctor learn how severe the arrhythmia is and may establish a need for other treatment including medications, Pacemaker, ICD, and ablation procedures.

EP Ablation
A procedure to eliminate an abnormal rapid heart rhythm. These rapid heart rhythms can include SVT’s or VT’s depending on where they arise in the heart. They are often caused by an abnormal “electrical circuit” in the heart that arises from a scar or extra electrical fibers. Using catheters inserted into the groin and up to the heart, these areas can be precisely located and cauterized by special catheters that can eliminate the “circuit” and often cure these abnormal heart rhythms.

Atrial Fibrillation Ablation
Atrial fibrillation is the most common arrhythmia we see in patients. Its treatment usually involves medications and blood thinners. Additionally, some patients are candidates for a special ablation procedure where a part of left upper chamber of the heart is electrically isolated from the rest of the heart. This involves catheters introduced into the heart through the veins of the groin that apply heat/cold and cauterize a part of the left upper chamber to try and separate the diseased areas from the heart that often leads to this arrhythmia.

Laser Lead Extraction
This is a procedure to extract the pacemaker or defibrillator leads from the heart. Usual reasons to do this procedure are due to infections in the heart or malfunction of the leads. This procedure is done under sedation or general anesthesia and device is accessed via the previous scar. Extraction procedure is done with the help of special Laser extraction device and involves removing the whole pacemaker or ICD system.

Implantable Loop Recorder
Implantable loop recorders are small heart rhythm recording devices that are implanted under the chest wall next to the breast bone. They are usually done to record abnormal heart rhythms that cannot be caught on external wearable recorders due to low frequency of occurrence. ILRs can be useful for patients who experience symptoms such as syncope (fainting), seizures, recurrent palpitations, lightheadedness, or dizziness. Battery lives for these devices are 2-3 years giving ample time for diagnosis. It is done as a same day procedure under local anesthesia and sedation.

Electrical Cardioversion
This procedure is done for patients with abnormal fast heart rhythms and most commonly atrial fibrillation. This is a same day procedure and is done under sedation. Once sedated as small electrical shock is delivered to the heart to ‘reset’ the heart to a normal rhythm.