Heart health (cardiology) in Nepean Blue Mountains

Pacemaker or defibrillator is a small device that's placed in the upper chest or, much less frequently, the abdomen to help control abnormal heart rhythms. This device sends electrical impulses to prompt the heart in circumstances where your heart rhythm has faltered or failed. Pacemakers are used to treat predominantly slow arrhythmias where the patient’s native heart rate is inadequate to sustain normal blood pressure.

Coronary angiogram is where access to the coronary arteries is via either the radial artery at the wrist or the femoral artery in the groin. From there, various catheters can be inserted and navigated to the coronary arteries to obtain images using radiographic contrast or dye, containing iodine that is injected into the coronary arteries, or bypass grafts, to outline the vessel involved.

Cardioversion refers to the treatment whereby a synchronised electrical shock is used to try to restore normal heart rhythm in patients with heart rhythm abnormalities. It is often recommended to patients with atrial fibrillation, a common heart rhythm disorder originating from the upper chambers of the heart (atria).

Coronary angioplasty (also known as percutaneous coronary intervention) or stenting is a procedure where a balloon catheter is inserted and inflated to open the narrowed coronary artery. The balloon catheter is then deflated and removed, resulting in an increased luminal diameter and hence increased blood flow in the coronary artery. The procedure may or may not include the insertion of a ‘stent/s’. A stent is a small tubular shaped stainless steel wire cage, which is inserted into the artery to hold it open and improve blood flow.

Electrophysiology (EP) studies is where a cardiologist places electrodes in different parts of the heart to determine electrical flow in the heart and also to see if any arrhythmias can be induced by electrical stimulation. Hence EP studies can help localise specific areas of heart tissue that may be giving rise to the abnormal electrical impulses that cause arrhythmias. This detailed electrical flow information provides valuable diagnostic and, therefore, treatment information.

Loop Recorder (ILR) insertion (or removal) is a small, thin device inserted under the skin that monitors and records your heart’s electrical activity over a long period of time in order to identify an irregular heart rhythm. The ILR can determine whether your symptoms are related to a heart rhythm problem.

Radiofrequency ablation is an invasive procedure that involves inserting catheters - narrow, flexible wires - into a blood vessel, often through a site in the groin or neck, and placing the wires in different regions of the heart. The journey from entry point to heart muscle is navigated by images created by a fluoroscope, an x-ray-like machine that provides continuous, live images of the catheter and tissue. Once the catheter reaches the heart, electrodes at the tip of the catheter gather data and a variety of electrical measurements are made. The data pinpoints the location of the faulty electrical site. During this electrical mapping, the cardiac arrhythmia specialist, an electrophysiologist, often sedates the patient and places a burn in an attempt to alleviate the area of heart electrical irritation. Once the damaged site is confirmed, energy is used to destroy a small amount of tissue, ending the disturbance of electrical flow through the heart and restoring a healthy heart rhythm.