Heart procedures and devices

If you have a heart problem, your doctor may want you to have a procedure or surgery done, or a device implanted. Below is an overview of some common heart procedures.
You should always discuss a procedure with your doctor, so you know exactly what's involved during and after.
Cardioversion
Cardioversion may be used to return your heart to a normal rhythm if you have an abnormal rhythm.
In electrical cardioversion, your heart is given a small electrical 'shock' while you're under an anaesthetic. In pharmacological cardioversion, medicines are used to return your heart to a normal rhythm.
Catheter ablation
Catheter ablation is sometimes used to treat abnormal heart rhythms.
The cardiologist inserts a long, thin tube (catheter) with an electrode at the tip into a blood vessel in your leg. The catheter travels up through the artery to your heart. The electrode emits radiofrequency waves to inactivate the part of the heart that’s creating or passing abnormal signals.
Coronary angioplasty and stent implantation
This is a procedure to open a narrowing in your artery. It improves blood flow to your heart.
The cardiologist inserts a small deflated balloon through a main artery in your groin or wrist, and moves it to the heart's artery, using an X-ray machine to see what they are doing.
The balloon is inflated inside the narrowed part of your artery.
After that, the cardiologist may use a stent to keep the artery open. A stent is a tiny expandable tube. The balloon is deflated and taken out and the stent stays in place, to help stop the narrowing recurring.
Defibrillation
Defibrillation helps to restore a normal heart rhythm when your heart stops beating properly during cardiac arrest. It may also be used to treat other heart rhythm problems (e.g. if your heart beats too fast).
Paddles or pads are put on your chest. A regulated electrical current is applied to your heart to make it start beating regularly again. If it is done urgently as a lifesaving measure time is of the essence and you may feel a thumping sensation in the chest. In less urgent situations you will be given a mild anaesthetic.
You may be given an implantable cardiac defibrillator (ICD) – see below.
Heart bypass (CABG or CAGS)
Its full name is coronary artery bypass graft surgery (CABG or CAGS - you might hear people call it 'cabbage').
When your coronary arteries are badly narrowed or blocked, treatments like medicines, angioplasty and stents may not work well enough. You may need surgery to improve blood flow to your heart, relieve angina symptoms and prevent heart attacks and more damage.
The surgeon takes a healthy blood vessel from somewhere else in your body and attaches it to either side of the blocked artery so that blood can bypass the blockage. The healthy blood vessel may be a vein from your leg, or an artery from inside your chest or your wrist.
Heart valve surgery
Sometimes a heart valve problem can be treated with procedures similar to coronary angioplasty. But if not, surgery may be needed. Heart valve surgery repairs or replaces heart valves that aren’t working properly, and helps your heart to pump blood.
To replace the valves, the surgeon may use mechanical valves or bio-prosthetic valves (specially treated valves from pigs or cows, or sometimes from human donors).
Implantable cardiac defibrillator (ICD)
An ICD is a small device that's put under the skin on your chest, and connected to your heart with electrodes.
An ICD can:
- correct an abnormal heartbeat (arrhythmia) by making your heart beat regularly
- give your heart controlled electric shocks to make it beat normally again if it has a life-threatening arrhythmia
- support the heartbeat (like a pacemaker) it it’s beating very slowly.
ICDs can also store information about your heart's activity for your doctor to check.
Pacemaker
The heart has a natural pacemaker to make it beat normally. If that’s not working reliably, an artificial pacemaker can be inserted to do the same job.
An artificial pacemaker is a small device that is put under the skin on your chest, below your collar bone. It has 1 or 2 wires that connect to your heart’s chambers. It produces small electrical currents that stimulate your heart to pump regularly.
Modern pacemakers are very reliable and sophisticated electronics detect when they are needed and the appropriate rate.
A pacemaker’s battery can last up to 10 years. Your doctor will check the battery every year, and replace it when needed.
Thrombolytic therapy
Thrombolytic therapy is a treatment in which you are given medicines through a drip to dissolve a blood clot that is narrowing or blocking a coronary artery.
This improves blood flow to your heart muscle and around your body.