Cardiology (Cardiac Catheter Lab/Cardiac Intervention Suite)

The Cardiac Intervention Suite sees patients with suspected heart problems.

The team conducts a number of assessments including Coronary Angiograms and Trans Oesphageal Echocardiogram and Pacing procedures to test the function of the heart, detect any problems and offer treatment and guidance.

Coronary Angiogram procedures are carried out under local anaesthetic and under light sedation, in a sterile theatre using x-ray equipment. The procedure is undertaken by a consultant cardiologist with a registered nurse in the theatre and also in recovery. There is also a senior radiographer and senior cardiac physiologist present taking readings during the procedure.

A small, fine needle/introducer is inserted into either the groin or wrist area and fine catheters are passed through this to the coronary arteries in the heart. Radio-opaque dye is inserted into the catheter and x-ray images are taken. These images show how the blood is flowing in the coronary arteries and diagnoses what may be causing the chest pain. Immediately after the procedure the patient will be given hot drinks and food.

The consultant will discuss with them what they have found and next steps for their treatment. A report will then be sent to their GP with all the information from the procedure.

The stay on the Cardiac Intervention Suite should be around four hours; the time in theatre is on average 30 minutes.

A Trans-Oesophageal Echo (TOE) procedure carried out in the theatre on the Cardiac Intervention Suite is done under local anaesthetic with spray to the throat and light sedation. The consultant cardiologist inserts a fine imaging probe into the mouth and passes this into the oesophagus (gullet) until it reaches where the heart is situated approximately six inches (15 cms). The cardiologist will be able to see images via ultrasound of all the valves within the heart and how they are working and if there is any infection present. The procedure takes about 20 minutes.

The patient is able to eat and drink when the local anaesthetic to the throat has worn off, about 60 minutes after the procedure.

Implantation of simple and complex pacemaker devices, implantable loop recorders and defibrillators is carried out under local anaesthetic and with light sedation, in a sterile theatre using imaging equipment. The procedure is undertaken by a consultant cardiologist with a registered nurse in the theatre and in recovery. There is also a senior radiographer and senior cardiac physiologist present taking readings during the procedure. A small incision is made into the left chest wall approximately six inches (15cms) from the shoulder. Small electronic leads are then inserted via the large arteries, that provide blood to/from the heart, into the heart muscle. These are then connected to a small computer which regulates the heartbeat. This is called a pacemaker and is inserted under the skin between the muscles in the chest wall.

The incision which is approximately three inches (7.5 cms) is closed with dissolvable sutures. The procedure takes approximately one to two hours in the theatre for simple devices and two-four hours for more complex procedures. The cardiac physiologists program the computer within the pacemaker to suit your individual needs in the recovery bay. All programming is done by a device that is used external to the skin and this is how they check it on a regular basis. This procedure is the same for all the devices. Pacemakers are approximately the size of a 50 pence piece. You will have an x-ray of the chest following the procedure to check everything is in the correct position.