Cardiac Cath Lab 

Using the latest in digital imaging technology, the Lakewood Regional Medical Center cardiac cath lab team assists your heart surgeon in diagnosing, evaluating and monitoring problems with the heart. 

Cardiac Catheterization 

A cardiac catheterization procedure (also called cardiac cath or heart catheterization procedure) is used to diagnose and treat various heart conditions. During catheterization, the surgeon guides a catheter, a small tube-like device, through your arteries to your coronary arteries. Once the catheter is in place, your surgeon can take images to assess the structure and function of your heart. The catheter can also be used for several other treatments, such as atrial fibrillation ablation, coronary stent placement, atrial septal defect closures and angioplasties. During cardiac catheterization, the doctor can:

• Check for narrowed or blocked blood vessels
• Look for heart valve problems
• Take a sample of heart tissue
• Measure blood flow and blood pressure in the heart
• Examine arteries from the heart to the lungs

Who Needs Cardiac Catheterization?

Cardiac catheterization is performed for different cardiac catheterization purposes:

• Better understanding of other test results – cardiac catheterization is helpful, especially when other tests performed don’t identify the problem or if the results differ from the initial diagnosis from the doctor
• Diagnosis of heart conditions – helps pinpoint the cause of symptoms like chest pain, irregular heartbeat or shortness of breath
• Evaluation before heart surgery – helps assess the overall condition of the heart before a transplant or any other heart surgery

However, cardiac catheterization is not for everyone. There are different factors to consider, and a doctor may not recommend cardiac catheterization if the patient has any of the following symptoms or conditions:

• Abnormal blood electrolyte levels
• Acute GI bleeding
• Acute kidney failure or severe kidney disease
• Acute stroke
• Blood too thin from blood-thinning medications
• High levels of digoxin (medication used to treat heart failure or arrhythmia)
• Allergic reaction to the dye used in cardiac catheterization
• Severe anemia
• Unexplained fever
• Untreated infection

How Serious is Cardiac Catheterization?

Heart catheterization is a minimally invasive procedure and is usually safe. Only a few people develop minor complications such as bruises at the puncture site and side effects such as feeling sick, itchiness or developing hives due to the contrast dye.

What Happens in a Cardiac Cath Lab?

Lakewood Regional Medical Center’s cardiac cath lab is staffed by a team of specialists led by a cardiologist. Interventional cardiologists are cardiologists with one to two years of additional education specializing in using catheters in cardiovascular procedures. Cath lab nurses and technologists are also present in the cath lab to monitor a patient’s condition, watch the monitors that display the heart rhythm and rate and notify the interventional cardiologist if they notice a change that may need immediate attention.

A cath lab shouldn’t be confused with an operating room where a person undergoes surgery under an anesthetic. Here’s a rundown of what to expect in a cath lab:

1. Preparation

The patient will be asked to change into a gown before entering the cath lab, and an IV will be inserted in the arm if there is a need to administer medications during the procedure. The heart cath procedure will be discussed, and a consent form will be signed before a patient is taken to the cath lab. Once in the cath lab, you will be asked to lie on an x-ray table with a mattress for between 30 minutes and a few hours, depending on the procedure. Your heart rhythm, blood pressure and oxygen levels will be closely monitored with the help of an ECG machine.

2. Heart Catheterization Procedure

The skin at either the groin, collarbone or neck will be cleaned with a special solution, a local anesthetic will be administered, a cannula will be inserted, and the catheters will be passed through the vein or artery to the heart. 

• Angiogram – a special dye will be passed through the catheter, and x-rays will be taken. The dye will help show the interventional cardiologist the blocked or narrowed arteries.
• Ablation – the tips of the catheters will help record the heart’s electrical activities. Sometimes, arrhythmias are triggered to identify what and where the problem is to help the cardiologist to know which areas to treat. Once identified, the ablation catheter is passed to deliver treatment.
• Pacemaker or ICD implantation – a small incision in the chest created to pass the lead(s) to the heart using a vein as a guide. The lead(s) will then be implanted in the heart and connected to the pacemaker. The pacemaker will then be inserted into the same incision and implanted under the skin. 

3. Test for Success

• Angiogram – the X-ray will show if the blood flow has been restored. If the patient has a seriously narrowed or blocked artery, they will feel better after the procedure.
• Ablation – After the ablation, the interventional cardiologist will test if the arrhythmia can still be triggered. If it’s still triggered, the search for the problematic area will continue until the arrhythmia isn’t triggered.
• Pacemaker or ICD implantation – the ECG should show if the device is already working. The interventional cardiologist will also check the lead(s) inserted.

4. Recovery

The catheter will be removed after the heart cath procedure. There may be a small amount of bleeding, and the nurse may press on the cut for a little while or insert a plug called an Angioseal. In most cases, a patient can go home the same day. However, an overnight stay may be required if the patient is undergoing additional procedures. 

After Heart Catheterization Procedure

Be sure to follow the instructions given by the cath lab nurses and interventional cardiologist. Medications should be taken as directed. Take note of follow-up appointments before leaving the hospital. Call a doctor if you experience any of the following symptoms:

• The puncture site becomes numb or tingles
• Your foot turns cold or blue
• The area of the puncture site looks more bruised
• Swelling or fluids is draining from the puncture site

Call 911 if the puncture site swells up very fast and the bleeding from the puncture site doesn’t slow down when pressed firmly.