Cardiac Procedures

There are more invasive tests and surgeries that are used to diagnose and treat your heart condition. 
This section will explore those procedures and surgeries that are performed routinely. 



In order to treat or eliminate abnormal heart rhythms (arrhythmias), an electrophysiologist uses ablation therapy.  Ablation typically uses radiofrequency (RF) energy that is applied to the heart tissue using special catheters.  These catheters destroy the tissue by heat or cold at the specific site causing the problem.


After the cardiac catheterization has determined that there are blockages in the coronary arteries, an angioplasty procedure can be performed.  This procedure involves having a balloon catheter inserted into the blocked coronary arteries.  The inflation of the balloon opens up the arteries so that blood flow can be returned through the arteries and to the heart.

Cardiac Catheterization

A small catheter or tube is placed in the artery at the groin, arm or hand and threaded into the heart.  The catheter allows doctors to inject dye and look at the vessels of the heart on x-ray to evaluate if there are any blockages of the coronary arteries that need treatment.  If treatment is needed to open a vessel an angioplasty or PCI (percutaneous coronary intervention) with or without placement of a stent can be performed.

Cardiac Resynchronization Therapy (CRT)

A CRT device is implanted just under the clavicle.  This device is used to treat heart failure patients and has the ability to coordinate the heart's electrical activity by pacing both the right and left sides of the heart.  The device can provide pacing alone to the right and left sides or can also defibrillate in case of abnormally fast heart rhythms.

Cardioversion Therapy

Cardioversion is a process of restoring the hearts normal rhythm from one that is abnormal. Most cardioversions are used to treat a condition called atrial fibrillation, a rhythm disturbance that causes the upper chambers (atria) of the heart to fibrillate or twitch in an uncoordinated way.  Atrial fibrillation can result in inefficient blood pumping and irregular or fast heartbeat.  Cardioversion applies direct current (DC) to shock the heart back into normal rhythm, with the hope of stopping the atrial fibrillation. Cardioversion is performed by placing electrical pads or paddles on the patient's chest.  A selected amount of energy is delivered to the heart.  Occasionally it is not possible to return the heart to its normal rhythm, or normal rhythm may only be obtained for a period of time before the atrial fibrillation begins again.

Coronary Artery Bypass Surgery (CABG)

This surgery is performed on patients with coronary artery disease to bypass areas of blockage.  Vessels from the legs or chest wall may be used that allow blood to flow past the diseased heart vessels.  The procedure can be done while your circulation is supported by a heart lung machine or as an "off pump" procedure which is also called beating heart surgery. 

Electrophysiology Study

This test will help diagnose a heart rhythm disturbance.  Small catheters are place in your groin and threaded into the heart.  The catheters have electrodes that can monitor your heart`s electrical system and can be recorded.  Various measurements will be taken from the catheters and you may feel your heart being paced to increase your heart rate.  You may be given certain medication to make the heart go faster or slower.

Heart Valve Surgery (Tricuspid, Mitral, Aortic, Pulmonic)

Surgery to repair the valves of the heart that are not functioning appropriately, can be done through conventional open heart surgery that uses the heart lung machine to provide blood flow to the body while the surgeon repairs the valve, or through a minimally invasive approach.  The valves can be repaired using sutures, and angioplasty rings or be replaced with a mechanical or tissue valve.

Implantable Cardioverter Defibrillator

A defibrillator is a device that is usually implanted under your clavicle but can also be placed in the abdomen.  This device has the ability to pace the heart if it beats too slowly or deliver a defibrillatory shock  to treat an abnormally fast heart rhythm.

Implantable Loop Recorder

A loop recorder is a small device that is implanted usually under the clavicle in patients that have syncope(fainting) to determine if the cause of syncope is from an abnormal heart rhythm.  Information on the patient`s heart activity is recorded on the device which is later analyzed.

Ventricular Assist Device

This device can be used for patients awaiting heart transplantation that needs support to the left ventricle to pump the blood to the rest of the body.  A pump is used to take the blood from the left ventricle and pumps it back into the aorta.  The tube that connects the heart to the pump (located outside the body) is worn outside of the body.  This portable device can allow the patient to be discharged from hospital until a donor heart becomes available.


A pacemaker is a device that is implanted just under the clavicle to prevent the heart from beating too slowly.  It can have both the upper and lower chamber (atria and ventricle) being paced (dual chamber pacemaker) or just the lower chamber (ventricle) being paced (single chamber pacemaker).  The pacemaker usually has a sensor that can detect how active you are and adjust your heart rate as needed.

Transcatheter Aortic Valve Intervention

This procedure treats patients with aortic stenosis that are not suitable for replacing the aortic valve through conventional open heart surgery.  A catheter is usually placed in the femoral artery at your groin, and the valve is threaded over the catheter and placed into the aortic valve position.  The valve can also be placed transapically (through the bottom of the left ventricle) through a small incision in the chest wall.


  • Heart and Stroke Foundation of Ontario
  • Mayo Clinic
  • Stanford Health Video Library
  • The Nuts and Bolts of Cardiac Resynchroniztion Therapy - Kenny 2007
  • The Nuts and Bolts of Cardiac Pacing- Kenny 2005
  • The Nuts and Bolts of ICD Therapy- Kenny 2006
  • Electrophysiologic Testing- Fogoros - Third Edition 1999
  • The American Heart Association