Procedures
Procedure technique & setup.
Equipment, sterile/anesthesia setup, mapping and ablation strategy, and pitfalls to anticipate — by case type.
Ablation procedures
AF Ablation (PVI)
Catheter-based pulmonary vein isolation to eliminate AF triggers. Energy options include pulsed field, radiofrequency, and cryoballoon; PVI is the foundation, with adjunctive lesions reserved for persistent disease.
Atrial Flutter Ablation (CTI)
Catheter ablation of the cavotricuspid isthmus to interrupt the typical right atrial flutter circuit. High success, short procedure, low complication rate.
AV Node Ablation
Catheter ablation of the AV node to produce complete heart block in patients with refractory atrial tachyarrhythmias who already have (or will receive) a ventricular pacing system. A short, high-yield procedure with a predictable workflow.
SVT Ablation
Catheter ablation of AVNRT, AVRT, or focal atrial tachycardia. Diagnostic EP study identifies the mechanism, ablation targets the critical substrate. High success, low complication rate.
VT Ablation
Substrate and activation-based catheter ablation of ventricular tachycardia. Strategy varies by substrate — idiopathic outflow tract VT differs fundamentally from scar-mediated VT in ischemic cardiomyopathy.
Device procedures
CRT Implant
Cardiac resynchronization therapy implant — adds an LV lead through the coronary sinus to a standard pacemaker (CRT-P) or ICD (CRT-D) to restore biventricular synchrony in heart failure with conduction delay.
ICD Implant (Transvenous)
Transvenous ICD implantation for primary or secondary prevention of sudden cardiac death. Workflow mirrors a pacemaker but with a high-voltage lead in the RV and tailored programming to minimize inappropriate shocks.
Pacemaker Implant (Transvenous)
Standard transvenous pacemaker implantation — single- or dual-chamber — performed in the EP lab with venous access, lead placement under fluoroscopy, generator pocket creation, and intraoperative parameter testing.