Procedures/Coronary

Cath Lab Procedures

- Coronary

Invasive Coronary Physiology Studies

These are procedures that take place in the catheter laboratory under local anaesthetic and sometimes with the addition of sedation administered into a vein. The procedure can be a day case procedure or sometimes requires an overnight stay. This procedure is performed if you have an issue with the electrical functioning of the heart.

The ablation procedure is slightly different depending on the underlying condition that is being treated.

Some examples of these procedures are described below.

This is a procedure that is often performed at the same time as a coronary angiogram. It is becoming more and more common to perform these studies as they provide much more accurate results than coronary angiography alone. When a coronary angiogram is performed, x-ray images of the coronary artery are displayed in a video format. From these pictures the doctor will make an estimation of the degree of narrowing of the coronary artery. If there are no narrowings or very severe narrowings, this judgement is usually correct. However, in the case of moderate narrowings, this ‘eyeball’ estimation can be misleading.
 
If the doctor is unsure how severe the narrowing is, they can introduce a special wire down the artery (often called a ‘pressure wire’) which is able to measure the flow of blood before and after the narrowing and given an accurate assessment of the severity of the narrowing. You may also be given a medication called adenosine during this procedure to increase the accuracy of the test (although this is not always necessary). If you are given medication then you may experience mild symptoms such as shortness of breath and chest discomfort whilst the medication is being administered. The procedure is very similar to a coronary angiogram and associated with similar complications. You may be asked to take a blood thinner tablet in advance of the procedure. 

Main points

1.  A diagnostic test to clarify whether narrowings in the heart arteries are significant

2. Performed at the same time as a coronary angiogram

You should always talk to your healthcare team about any procedure you're going to have and make sure it is right for you.

oct coro image.jpg

Image from:

Cuesta et al. Circulation: Cardiovascular Interventions. 2017;10:e005232