Writer: Brain Guo

Modern medicine has developed highly advanced procedures that can treat many of the issues that can affect the heart without having to open the chest. One of the most important of these procedures involves the use of catheters to access the heart. These procedures are used, for instance, to open blocked arteries or to correct irregular heart rhythms. While many people may describe these procedures in simple terms as “inserting a rod into the heart and burning a blood vessel,” the procedure is actually much more precise and scientific in its performance. Two of the most common catheter procedures are angioplasty with stent placement and cardiac ablation.

To understand how these procedures work, it is first important to gain an understanding of the heart and blood vessel system itself. The heart is a muscular organ that pumps blood throughout the body. Blood travels through the arteries. Over time, the arteries can become blocked by the buildup of plaque. Additionally, the heart may develop electrical problems that cause it to beat too quickly, too slowly or irregularly. Each of these problems can be life-threatening if not treated.

In place of performing surgery on the heart, doctors can use a catheter to treat the heart. A catheter is a thin, flexible tube. It is often mistaken for a rod, but the catheter is actually soft and bendable. In order to perform the procedure on the heart, the patient is first numbed in the area where the catheter will be inserted. The doctor then makes an incision, inserts a sheath into a blood vessel, and inserts the catheter through that sheath.

The doctor uses X-ray imaging to observe the catheter as it is being inserted into the body. The catheter can be guided through the blood vessels to the heart. Different procedures can be performed once the catheter is within the heart.

One of the most common catheter procedures is angioplasty with stent placement. Angioplasty is used to treat coronary artery disease, which is caused by the blockages in the arteries that supply blood to the heart. When the catheter is positioned at the blocked artery, a balloon is inflated. The inflation of the balloon helps to push the plaque against the walls of the artery, allowing the artery to widen and permit blood to again flow to the heart.

Often, a stent is placed during this procedure. A stent is a small, mesh-like metal tube. After the blood vessels are widened with the inflation of the balloon, the stent is positioned at the same spot within the artery. Over time, the artery grows around the stent, securing it in place. This prevents the artery from becoming blocked once again. Angioplasty with stent placement is one of the most effective procedures for treating coronary artery disease.

Another of the most common catheter procedures is cardiac ablation. Cardiac ablation is a procedure used to treat arrhythmias, which are abnormal heart rhythms. The heart naturally has electrical problems that cause it to normally beat. Sometimes, however, the heart develops additional electrical pathways that cause the heart to beat rapidly or irregularly.

During cardiac ablation, the catheter is placed into the heart. Once within the heart, the catheter’s sensors map the heart’s electrical system. The map created by the sensors allows the doctor to recognize the location of the additional electrical pathways. Once located, the catheter delivers energy to destroy a small area of the heart. This “burning” of the heart is not accurate; rather, the energy creates heat to form a scar on the heart tissue.

The precision with which the catheter can be guided to the heart to perform the ablation is among the greatest advantages of this procedure. Only a small portion of the heart is “burned” with the energy. The heart is able to continue to normally function, but the faulty electrical pathway is disabled. The abnormal heart rhythms are, therefore, prevented.

Both angioplasty and cardiac ablation procedures utilize numerous different technologies. For instance, the procedure may utilize 3D mapping systems to map the heart and identify the blocked artery or electrical pathway. Sensors are attached to the catheter to monitor the heart.

During the procedure, patients are awake but somewhat sedated. Additionally, the body’s blood vessels do not contain the receptors for feeling pain. Patients, therefore, do not feel the catheter as it passes through the blood vessels.

After the procedure, the catheter is removed. The insertion site is closed. These procedures take less time to perform than open-heart surgery, and patients recover more quickly. After angioplasty, patients can typically leave the hospital within a day or two. After cardiac ablation, patients typically recover in a few days. Patients are often given blood thinners or anti-arrhythmic drugs to aid in their recovery.

The procedures are generally safe. However, complications can occur. These may include blood clots, irregular heartbeats, blood vessel damage or bleeding at the insertion site. These complications, however, are relatively rare.

Overall, inserting a catheter into the body to reach the heart is one of the most important advancements in medicine. By inserting such a thin catheter into the body, doctors are able to reach the heart without performing an open-heart surgery. Whether they are using angioplasty to open an artery or using cardiac ablation to disable an electrical pathway in the heart, the procedures are precise and effective. While the procedures may be described in simple terms as “inserting a rod into the heart and burning a blood vessel,” the actual procedure is one of the most important in medicine and saves the lives of millions of patients each year.