A catheterization laboratory, commonly referred to as a cath lab, is an examination room in a hospital or clinic with

diagnostic imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...

equipment used to visualize the arteries of the heart and the chambers of the

heart The heart is a muscular Organ (biology), organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrie ...

and treat any

stenosis Stenosis () is the abnormal narrowing of a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' as a term is usually used when narrowing ...

or abnormality found.

Equipment

Most catheterization laboratories are "single plane" facilities, those that have a single

X-ray An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

generator source and an

X-ray image intensifier An X-ray image intensifier (XRII) is an image intensifier that converts X-rays into visible light at higher intensity (physics), intensity than the more traditional fluorescence, fluorescent screens can. Such intensifiers are used in X-ray imagin ...

for

fluoroscopic Fluoroscopy (), informally referred to as "fluoro", 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 surgeon to see t ...

imaging. Older cath labs used cine film to record the information obtained, but since 2000, most new facilities are

digital Digital usually refers to something using discrete digits, often binary digits. Businesses *Digital bank, a form of financial institution *Digital Equipment Corporation (DEC) or Digital, a computer company *Digital Research (DR or DRI), a software ...

. The latest digital cath labs are biplane (have two X-ray sources) and use

flat panel detector Flat-panel detectors are a class of solid-state x-ray digital radiography devices similar in principle to the image sensors used in digital photography and video. They are used in both projectional radiography and as an alternative to x-ray ima ...

Staff

Cardiac catheterization laboratories are usually staffed by a multidisciplinary team. This may include a medical practitioner (normally either a consultant

cardiologist Cardiology () is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery di ...

radiologist Radiology ( ) is the medical specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but tod ...

), cardiac

physiologist Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a subdiscipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out chemical and ...

radiographer Radiographers, also known as radiology technologists, radiologic technologists, diagnostic radiographers and medical radiation technologists, are healthcare professionals who specialise in the imaging of human anatomy for the diagnosis and tr ...

and

nurse Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alle ...

Medical practitioner (interventional cardiologist/electrophysiologist)

The consultant cardiologist is responsible for gaining arterial access, inserting a sheath into either the

radial Radial is a geometric term of location which may refer to: Mathematics and Direction * Vector (geometric), a line * Radius, adjective form of * Radial distance (geometry), a directional coordinate in a polar coordinate system * Radial set * A ...

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 and descends along the anteromedial part of the thigh in the femoral triangle. It enters ...

, passing a wire and

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

into the coronary artery and selectively injecting

contrast media A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radio ...

into the coronary arteries. They then interpret the images taken to ascertain where the narrowed or blocked artery has the problem. They use a variety of techniques and imaging tools to measure the size of things such as balloons and

stent In medicine, a stent is a tube usually constructed of a metallic alloy or a polymer. It is inserted into the Lumen (anatomy), lumen (hollow space) of an anatomic vessel or duct to keep the passageway open. Stenting refers to the placement of ...

Cardiac physiologist

Cardiac physiologists usually set up what is known as a

transducer A transducer is a device that Energy transformation, converts energy from one form to another. Usually a transducer converts a signal in one form of energy to a signal in another. Transducers are often employed at the boundaries of automation, M ...

to monitor pressure in the arteries. They also have a live view of the patients

ECG Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of ...

so they can tell whether or not there is a problem caused by the insertion of the catheter into the heart to the electrical pathways. The physiologist will also set up a temporary pacemaker if the procedure is an angioplasty or a

percutaneous coronary intervention Percutaneous coronary intervention (PCI) is a minimally invasive non-surgical procedure used to treat stenosis, narrowing of the coronary artery, coronary arteries of the heart found in coronary artery disease. The procedure is used to place and ...

(PCI). Finally, they also set up

defibrillator Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). Defibrillation delivers a dose of electric current (often called a ''count ...

s on to the patient for emergency use if needed. In some locations, some of these responsibilities may be carried out by other personnel, such as trained nurses or technologists.

Procedures

Cardiac catheterization Cardiac catheterization (heart cath) is the insertion of a catheter into a heart chamber, chamber or Blood vessel, vessel of the heart. This is done both for diagnostic and interventional purposes. A common example of cardiac catheterization is c ...

is a general term for a group of procedures that are performed in the cath lab, such as

coronary angiography Coronary () may, as shorthand in English, be used to mean: * Coronary circulation, the system of arteries and veins in mammals ** Coronary artery disease ** Coronary occlusion ** A myocardial infarction, a heart attack As adjective * Referring to ...

. Once a catheter is in place, it can be used to perform a number of procedures including

angioplasty Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty, is a minimally invasive procedure, minimally invasive endovascular surgery, endovascular Medical procedure, procedure used to widen narrowed or obstructe ...

, PCI (

) angiography,

transcatheter aortic valve replacement Transcatheter aortic valve replacement (TAVR) is the implantation of the aortic valve of the heart through the blood vessels without actual removal of the native valve (as opposed to the aortic valve replacement by open heart surgery, surgical ...

balloon septostomy A balloon septostomy is the widening of the foramen ovale, a patent foramen ovale (PFO), or an atrial septal defect (ASD) via cardiac catheterization using a balloon catheter. This procedure allows for a greater amount of oxygenated blood to ent ...

, and an

electrophysiology study A cardiac electrophysiology study (EP test or EP study) is a Invasiveness of surgical procedures, minimally invasive procedure using catheters introduced through a vein or artery to record electrical activity from within the heart. This electric ...

catheter ablation Catheter ablation is a procedure that uses radio-frequency energy or other sources to terminate or modify a faulty electrical pathway from sections of the heart of those who are prone to developing cardiac arrhythmias such as atrial fibrillation ...

. Devices such as

pacemaker A pacemaker, also known as an artificial cardiac pacemaker, is an implanted medical device that generates electrical pulses delivered by electrodes to one or more of the chambers of the heart. Each pulse causes the targeted chamber(s) to co ...

s may be fitted or rotablation to remove plaque can be performed.

References

External links

MedlinePlus Medical Encyclopedia: Cardiac catheterization

Observational study on cases of brain and neck tumors among cath lab operators
{{Cardiac procedures Medical testing equipment Cardiac procedures Cardiac imaging Cardiac surgery Interventional cardiology