Cardiac Catheterization
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Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the
heart The heart is a muscular organ found in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon diox ...
. This is done both for diagnostic and interventional purposes. A common example of cardiac catheterization is coronary catheterization that involves catheterization of the coronary arteries for
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves Ischemia, the reduction of blood flow to the myocardium, heart muscle due to build-up o ...
and
myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ...
s ("heart attacks"). Catheterization is most often performed in special laboratories with
fluoroscopy Fluoroscopy () is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a physician to see the internal structure and functi ...
and highly maneuverable tables. These "cath labs" are often equipped with cabinets of catheters, stents, balloons, etc. of various sizes to increase efficiency. Monitors show the fluoroscopy imaging, electrocardiogram (ECG), pressure waves, and more.


Uses

Coronary angiography is a diagnostic procedure that allows visualization of the coronary vessels. Fluoroscopy is used to visualize the lumens of the arteries as a 2-D projection. Should these arteries show narrowing or blockage, then techniques exist to open these arteries. Percutaneous coronary intervention is a blanket term that involves the use of mechanical stents, balloons, etc. to increase blood flow to previously blocked (or occluded) vessels. Measuring pressures in the heart is also an important aspect of catheterization. The catheters are fluid filled conduits that can transmit pressures to outside the body to pressure transducers. This allows measuring pressure in any part of the heart that a catheter can be maneuvered into. Measuring blood flow is also possible through several methods. Most commonly, flows are estimated using the Fick principle and thermodilution. These methods have drawbacks, but give invasive estimations of the cardiac output, which can be used to make clinical decisions (e.g.,
cardiogenic shock Cardiogenic shock (CS) is a medical emergency resulting from inadequate blood flow due to the dysfunction of the ventricles of the heart.Textbooks of Internal MedicinHarrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill Compan ...
,
heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, ...
) to improve the person's condition. Cardiac catheterization can be used as part of a therapeutic regimen to improve outcomes for survivors of out-of-hospital cardiac arrest. Cardiac catheterization often requires the use of
fluoroscopy Fluoroscopy () is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a physician to see the internal structure and functi ...
to visualize the path of the catheter as it enters the heart or as it enters the coronary arteries. The coronary arteries are known as "epicardial vessels" as they are located in the epicardium, the outermost layer of the heart. The use of fluoroscopy requires radiopaque contrast, which in rare cases can lead to contrast-induced kidney injury (see Contrast-induced nephropathy). People are constantly exposed to low doses of ionizing radiation during procedures. Ideal table positioning between the x-ray source and receiver, and
radiation monitoring Radiation monitoring involves the measurement of radiation dose or radionuclide contamination for reasons related to the assessment or control of exposure to radiation or radioactive substances, and the interpretation of the results. Environment ...
via thermoluminescent dosimetry, are two main ways of reducing a person's exposure to radiation. People with certain comorbidities (people who have more than one condition at the same time) have a higher risk of adverse events during the cardiac catheterization procedure. These comorbidity conditions include
aortic aneurysm An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be abdominal, back, or leg pain. The prevalence of abdominal aorti ...
, aortic stenosis, extensive three-vessel
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves Ischemia, the reduction of blood flow to the myocardium, heart muscle due to build-up o ...
,
diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level (hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
, uncontrolled hypertension,
obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...
,
chronic kidney disease Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, ...
, and unstable angina.


Left heart catheterization

Left heart catheterization (LHC) is an ambiguous term and sometime clarification is required: * LHC can mean measuring the pressures of the left side of the heart. * LHC can be synonymous with coronary angiography. technique is also used to assess the amount of occlusion (or blockage) in a coronary artery, often described as a percentage of occlusion. A thin, flexible wire is inserted into either the
femoral artery The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or profunda femoris artery and descends along the anteromedial part of the thigh in the f ...
or the
radial artery In human anatomy, the radial artery is the main artery of the lateral aspect of the forearm. Structure The radial artery arises from the bifurcation of the brachial artery in the antecubital fossa. It runs distally on the anterior part of th ...
and threaded toward the heart until it is in the ascending
aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ...
. Radial access is not associated with an increased risk of stroke over femoral access. At this point, a catheter is guided over the wire into the ascending aorta, where it can be maneuvered into the coronary arteries through the coronary ostia. In this position, the interventional cardiologist can inject contrast and visualize the flow through the vessel. If necessary, the physician can utilize percutaneous coronary intervention techniques, including the use of a stent (either bare-metal or drug-eluting) to open the blocked vessel and restore appropriate blood flow. In general, occlusions greater than 70% of the width of the vessel lumen are thought to require intervention. However, in cases where multiple vessels are blocked (so-called "three-vessel disease"), the interventional cardiologist may opt instead to refer the patient to a cardiothoracic surgeon for coronary artery bypass graft (CABG; see
Coronary artery bypass surgery Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pai ...
) surgery.


Right heart catheterization

Right heart catheterization (RHC) allows the physician to determine the pressures within the heart (intracardiac pressures). The heart is most often accessed via the internal jugular or femoral vein; arteries are not used. Values are commonly obtained for the right atrium, right ventricle, pulmonary artery, and pulmonary capillary "wedge" pressures. Right heart catheterizations also allow the physician to estimate the cardiac output, the amount of blood that flows from the heart each minute, and the cardiac index, a hemodynamic parameter that relates the cardiac output to a patient's body size. Determination of cardiac output can be done by releasing a small amount of saline solution (either chilled or at room temperature) in one area of the heart and measuring the change in blood temperature over time in another area of the heart. Right heart catheterization is often done for pulmonary hypertension,
heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, ...
, and
cardiogenic shock Cardiogenic shock (CS) is a medical emergency resulting from inadequate blood flow due to the dysfunction of the ventricles of the heart.Textbooks of Internal MedicinHarrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill Compan ...
. The pulmonary artery catheter can be placed, used, and removed, or it can be placed and left in place for continuous monitoring. The latter can be done an
intensive care unit 220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensi ...
(ICU) to permit frequent measurement of the hemodynamic parameters in response to interventions. Parameters obtainable from a right heart catheterization: * Right atrial pressure * Right ventricular pressure * Pulmonary artery pressure * Pulmonary capillary wedge pressure * Systemic vascular resistance * Pulmonary vascular resistance * Cardiac output * Blood oxygenation Implantation of a CardioMEMS is done during a right heart catheterization. This device is implanted into the pulmonary artery to permit real-time measurement of the pulmonary artery pressure over time.


Coronary catheterization

Coronary catheterization is an invasive process and comes with risks that include stroke, heart attack, and death. Like any procedure, the benefits should outweigh the risks and so this procedure is reserved for those with symptoms of serious heart diseases and is never used for screening purposes. Other, non-invasive tests are better used when the diagnosis or certainty of the diagnosis is not as clear. Indications for cardiac catheterization include the following: * Acute coronary syndromes: ST elevation MI (STEMI), non-ST Elevation MI (NSTEMI), and unstable angina * Evaluation of
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves Ischemia, the reduction of blood flow to the myocardium, heart muscle due to build-up o ...
as indicated by ** Abnormal stress test ** As part of the pre-op evaluation for other cardiac procedures (e.g., valve replacement) as coronary artery bypass grafting may be done at the same time ** Risk stratification for high cardiac risk surgeries (e.g.,
endovascular aneurysm repair Endovascular aneurysm repair (EVAR) is a type of minimally-invasive endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). When used to treat thoracic aortic disease, the procedure is then ...
) * Persistent chest pain despite medical therapy thought to be cardiac in origin * New-onset unexplained heart failure * Survival of
sudden cardiac death Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
or dangerous cardiac arrhythmias * Workup of suspected Prinzmetal angina ( coronary vasospasm) Right heart catheterization, along with
pulmonary function testing Pulmonary function testing (PFT) is a complete evaluation of the respiratory system including patient history, physical examinations, and tests of pulmonary function. The primary purpose of pulmonary function testing is to identify the severity ...
and other testing should be done to confirm pulmonary hypertension prior to having
vasoactive A vasoactive substance is an endogenous agent or pharmaceutical drug that has the effect of either increasing or decreasing blood pressure and/or heart rate through its vasoactivity, that is, vascular activity (effect on blood vessels). By adj ...
pharmacologic treatments approved and initiated. * to measure intracardiac and intravascular
blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressur ...
s * to take tissue samples for
biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a d ...
* to inject various agents for measuring blood flow in the heart; also to detect and quantify the presence of an intracardiac shunt * to inject contrast agents in order to study the shape of the heart vessels and chambers and how they change as the heart beats


Pacemakers and defibrillators

Placement of internal
pacemaker An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart ei ...
s and
defibrillator Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''coun ...
s are done through catheterization as well. An exception to this is placement of electrodes on the outer surface of the heart (called epicardial electrodes). Otherwise, electrodes are placed through the venous system into the heart and left there permanently. Typically, these devices are placed in the left upper chest and enter the left subclavian vein and electrodes are placed in the right atrium, right ventricle, and coronary sinus (for the left ventricle stimulation).


Valve assessment

Echocardiography An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in ...
is a non-invasive method to evaluate the heart valves. However, sometimes the valve pressure gradients need to be measured directly because echo is equivocal for the severity of valve disease. Invasive assessment of the valve can be done with catheterization by placing a catheter across the valve and measuring the pressures simultaneously on each side of the valve to obtain the pressure gradient.Grossman & Baim's cardiac catheterization, angiography, and intervention. Moscucci, Mauro, (Eighth edition). Philadelphia. p. 272. . OCLC 829739969. In conjunction with a right heart catheterization, the valve area can be estimated. For example, in aortic valve area calculation the Gorlin equation can be used to calculate the area if the cardiac output, pressure gradient, systolic period, and heart rate are known.


Pulmonary angiography

Evaluation of the blood flow to the lungs can be done invasively through catheterization. Contrast is injected into the pulmonary trunk, left or right pulmonary artery, or segment of the pulmonary artery.


Shunt evaluation

Cardiac shunts can be evaluated through catheterization. Using oxygen as a marker, the oxygen saturation of blood can be sampled at various locations in and around the heart. For example, a left-to-right atrial septal defect will show a marked increase in oxygen saturation in the right atrium, ventricle, and pulmonary artery as compared to the mixed venous oxygen saturation from the oxygenated blood from the lungs mixing into the venous return to the heart. Utilizing the Fick principle, the ratio of blood flow in the lungs (Qp) and system circulations (Qs) can calculate the Qp:Qs ratio. Elevation of the Qp:Qs ratio above 1.5 to 2.0 suggests that there is a hemodynamically significant left-to-right shunt (such that the blood flow through the lungs is 1.5 to 2.0 times more than the systemic circulation). This ratio can be evaluated non-invasively with
echocardiography An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in ...
too, however. A "shunt run" is often done when evaluating for a shunt by taking blood samples from
superior vena cava The superior vena cava (SVC) is the anatomical terms of location#Superior and inferior, superior of the two venae cavae, the great vein, venous trunks that return deoxygenated blood from the circulatory system, systemic circulation to the atrium ...
(SVC),
inferior vena cava The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of th ...
(IVC),
right atrium The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two a ...
,
right ventricle A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper ...
,
pulmonary artery A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and ...
, and system arterial. Abrupt increases in oxygen saturation support a left-to-right shunt and lower than normal systemic arterial oxygen saturation supports a right-to-left shunt. Samples from the SVC & IVC are used to calculate mixed venous oxygen saturation.


Ventriculography

By injecting contrast into the left ventricle, the outline of the ventricle can be measured in both systole and diastole to estimate the
ejection fraction An ejection fraction (EF) is the volumetric fraction (mathematics), fraction (or portion of the total) of fluid (usually blood) ejected from a chamber (usually the heart) with each contraction (or cardiac cycle, heartbeat). It can refer to the card ...
(a marker of heart function). Due to the high contrast volumes and injection pressures, this is often not performed unless other, non-invasive methods are not acceptable, not possible, or conflicting.


Percutaneous aortic valve replacement

Advancements in cardiac catheterization have permitted replacement of heart valves by means of blood vessels. This method allows
valve replacement Valve replacement surgery is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis ( homograft from human tissue or xenograft e.g. from pig). It is an alternative to valve repair. __TOC__ Proc ...
without open heart surgery and can be performed on people who are high-risk for such a surgery.


Balloon septostomy

Catheterization can also be used to perform balloon septostomy, which is the widening of a
foramen ovale There are multiple structures in the human body with the name foramen ovale (plural: ''foramina ovalia''; Latin for "oval hole"): * Foramen ovale (heart), in the fetal heart, a shunt from the right atrium to left atrium * Foramen ovale (skull), at ...
, patent foramen ovale (''PFO''), or atrial septal defect (''ASD'') using a balloon catheter. This can be done in certain congenital heart diseases in which the mechanical shunting is required to sustain life such as in transposition of the great vessels.


Alcohol septal ablation

Hypertrophic cardiomyopathy Hypertrophic cardiomyopathy (HCM, or HOCM when obstructive) is a condition in which the heart becomes thickened without an obvious cause. The parts of the heart most commonly affected are the interventricular septum and the ventricles. This r ...
is a disease in which the myocardium is thickened and can cause blood flow obstruction. If hemodynamically significant, this excess muscle can be removed to improve blood flow. Surgically, this can be done with
septal myectomy Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). The open-heart surgery entails removing a portion of the septum that is obstructing the flow of blood from the left ventricle to the aorta. The most common a ...
. However, it can be done through catheterization and by injecting
ethanol Ethanol (abbr. EtOH; also called ethyl alcohol, grain alcohol, drinking alcohol, or simply alcohol) is an organic compound. It is an alcohol with the chemical formula . Its formula can be also written as or (an ethyl group linked to a h ...
to destroy the tissue in an
alcohol septal ablation Alcohol septal ablation (ASA) is a minimally invasive heart procedure to treat hypertrophic cardiomyopathy (HCM). It is a percutaneous, minimally invasive procedure performed by an interventional cardiologist to relieve symptoms and improve func ...
. This is done by selected an appropriate septal artery supplying the intended area and, essentially, causing a localized, controlled
myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ...
of the area with ethanol.


Complications

Complications of cardiac catheterization and tools used during catheterization include, but not limited to: * Death * Stroke * Heart attack * Ventricular ectopy and ventricular arrhythmias *
Pericardial effusion A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of ...
* Bleeding: internal and external * Infection * Radiation burn * Contrast induced nephropathy from contrast use The likelihood of these risks depends on many factors that include the procedure being performed, the overall health state of the patient, situational (elective vs emergent), medications (e.g., anticoagulation), and more.


Procedure

"Cardiac catheterization" is a general term for a group of procedures. Access to the heart is obtained through a peripheral artery or vein. Commonly, this includes the
radial artery In human anatomy, the radial artery is the main artery of the lateral aspect of the forearm. Structure The radial artery arises from the bifurcation of the brachial artery in the antecubital fossa. It runs distally on the anterior part of th ...
,
internal jugular vein The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the post ...
, and
femoral artery The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or profunda femoris artery and descends along the anteromedial part of the thigh in the f ...
/
vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenate ...
. Each blood vessel has its advantages and disadvantages. Once access is obtained, plastic catheters (tiny hollow tubes) and flexible wires are used to navigate to and around the heart. Catheters come in numerous shapes, lengths, diameters, number of lumens, and other special features such as electrodes and balloons. Once in place, they are used to measure or intervene. Imaging is an important aspect to catheterization and commonly includes fluoroscopy but can also include forms of
echocardiography An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in ...
( TTE, TEE,
ICE Ice is water frozen into a solid state, typically forming at or below temperatures of 0 degrees Celsius or Depending on the presence of impurities such as particles of soil or bubbles of air, it can appear transparent or a more or less opaq ...
) and ultrasound (
IVUS Intravascular ultrasound (IVUS) or intravascular echocardiography is a medical imaging methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the ca ...
). Obtaining access uses the Seldinger technique by puncturing the vessel with a needle, placing a wire through the needle into the lumen of the vessel, and then exchanging the needle for a larger plastic sheath. Finding the vessel with a needle can be challenging and both ultrasound and fluoroscopy can be used to aid in finding and confirming access. Sheaths typically have a side port that can be used to withdraw blood or injection fluids/medications, and they also have an end hole that permits introducing the catheters, wires, etc. coaxially into the blood vessel. Once access is obtained, what is introduced into the vessel depends on the procedure being performed. Some catheters are formed to a particular shape and can really only be manipulated by inserting/withdrawing the catheter in the sheath and rotating the catheter. Others may include internal structures that permit internal manipulation (e.g.,
intracardiac echocardiography Intracardiac injections are injections that are given directly into the heart muscles or ventricles. They can be used in emergencies, although they are rarely used in modern practice. History The practice of intracardiac injection originated in ...
). Finally, when the procedure is completed, the catheters are removed and the sheath is removed. With time, the hole made in the blood vessel will heal.
Vascular closure device Vascular closure devices (VCDs) are medical devices used to achieve hemostasis of the small hole in the artery after a cardiovascular procedure of endovascular surgery requiring a catheterization. Cardiovascular procedures requiring catheterizatio ...
s can be used to speed along hemostasis.


Equipment

Much equipment is required for a facility to perform the numerous possible procedures for cardiac catheterization. General: * Catheters * Film or Digital Camera * Electrocardiography monitors * External defibrillator * Fluoroscopy * Pressure transducers * Sheaths Percutaneous coronary intervention: * Coronary stents: bare-metal stent (BMS) and drug-eluting stent (DES) * Angioplasty balloons * Atherectomy lasers and rotational devices *
Left atrial appendage occlusion Left atrial appendage occlusion (LAAO), also referred to as left atrial appendage closure (LAAC), is a treatment strategy to reduce the risk of blood clots from the left atrial appendage entering the bloodstream and causing a stroke in those with ...
devices Electrophysiology: *
Ablation Ablation ( la, ablatio – removal) is removal or destruction of something from an object by vaporization, chipping, erosive processes or by other means. Examples of ablative materials are described below, and include spacecraft material for a ...
catheters: radiofrequency (RF) and cryo *
Pacemaker An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart ei ...
s *
Defibrillator Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''coun ...
s


History

The history of cardiac catheterization dates back to Stephen Hales (1677-1761) and Claude Bernard (1813-1878), who both used it on animal models. Clinical application of cardiac catheterization begins with Dr. Werner Forssmann in 1929, who inserted a catheter into the vein of his own forearm, guided it fluoroscopically into his right atrium, and took an
X-ray X-rays (or rarely, ''X-radiation'') are a form of high-energy electromagnetic radiation. In many languages, it is referred to as Röntgen radiation, after the German scientist Wilhelm Conrad Röntgen, who discovered it in 1895 and named it ' ...
picture of it. However, even after this achievement, hospital administrators removed Forssmann from his position owing to his unorthodox methods. During
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the World War II by country, vast majority of the world's countries—including all of the great power ...
, André Frédéric Cournand, a physician at NewYork-Presbyterian/Columbia, then Columbia-Bellevue, opened the first catheterization lab. In 1956, Forssmann and Cournand were co-recipients of the Nobel Prize in Physiology or Medicine for the development of cardiac catheterization. Dr. Eugene A. Stead performed research in the 1940s, which paved the way for cardiac catheterization in the USA.


References


External links


MedlinePlus Medical Encyclopedia: Cardiac catheterization


{{Authority control Cardiac procedures Diagnostic cardiology