Invasive Electrophysiological exam, Catheter ablation; Primary and Secondary prevention in Cardiology and Angiology Flashcards
What is Invasive Electrophysiological Exam?
It is an invasive cardiac exam where an Electrophysiological study is done using catheters introduced through a vein or an artery, in order to record electrical activity of heart, induce arrhythmia is suspect patients as dx and in the same sitting, conduct catheter ablation to problematic cells/areas in heart
Which vessels are used for catheter insertion?
Femoral veins or Subclavian veins
Femoral Artery
Common Indications for Electrophysiological exam
- Preceeding the planned ablation for documented Narrow QRS Tachycardias
- Preceeding the planned ablation for documented Macro-reentrant Atrial Tachycardias [Typical and Atypical Atrial Flutter]
- Preceeding the planned ablation of Ventricular Tachycardias or Ventricular Extrasytole
- Ddx of Wide QRS Tachycardias [Ventricular vs Supraventricular with BBB]
- Paroxysmal palpitation without ECG documentation
- Syncope of unknown cause and Structural heart disease [previous MI, Impaired LV function]
- Risk stratification in patients with high risk for Ventricular arrhythmias, mostly to guide ICD placements
Methods for Catheter Ablation
- High Energy Radio Frequency [~ 50 degrees C]
- More recent, Cryoablation
Imaging used to guide Catheter ablation and Electrophysiological exam
- Portable Xray imaging
- Non-fluoroscopic electroanatomical mapping systems
What is considered as Primary Prevention in Cardiology and Angiology?
Primary prevention refers to therapies and modifications in lifestyle in order to prevent an occurence of Heart-based disease or ensure that no progression to a heart disease is made
Methods include:
- Diet changes
- Smoking Cessation
- Reduced Alcohol intake
- Increased Physical activity
- Losing weight in Obesity
- Management of Diabetes Mellitus with medications
- Management of Hypertension with medications [Diuretics, Beta Blockers, ACEis, ARBs]
- Management of Hyperlipidemia with medications [Statins, HMG-CoA Reductase Inhibs]
What is considered as Secondary Prevention in Cardiology and Angiology?
Secondary Prevention focuses on the reduction of impact from diagnoses CVD through Early Diagnosis and Appropriate Treatment regimes, its adherence AND bringing about Lifestyle modifications
Regular health checkups and Followups, Adherance to medication, changes in Lifestyle, all are part of Secondary Prevention
