Coronary Angiography (CAG) is a specialized diagnostic procedure used to visualize the coronary arteries — the blood vessels that supply the heart muscle. It helps detect blockages, narrowing, or abnormalities in the arteries that may cause chest pain, heart attacks, or other cardiac conditions. What is CAG? CAG is performed using a contrast dye and X-ray imaging (fluoroscopy). A thin, flexible catheter is inserted through the wrist or groin artery and guided to the coronary arteries. Once the contrast dye is injected, X-ray images are taken to show the flow of blood through the coronary vessels. When is Coronary Angiography recommended? Chest pain (angina) or tightness Positive stress test or abnormal ECG Suspected or confirmed heart attack (MI) Coronary artery disease risk in diabetic or high-risk patients Prior to angioplasty (PCI) or cardiac surgery What does it reveal? Location and severity of arterial narrowing or blockage Condition of the heart chambers and valves Need for further intervention such as angioplasty or bypass surgery Procedure Highlights Minimally invasive, typically done under local anesthesia Takes about 20–30 minutes Most patients are discharged the same or next day Performed in a dedicated Cath Lab by expert interventional cardiologist Dr.Chetan Jain

1. Pacemaker A pacemaker is a small, battery-operated device implanted under the skin (usually near the collarbone) to help regulate abnormally slow heart rhythms (bradycardia). When is it needed? Sinus node dysfunction Heart block (AV block) Symptomatic bradycardia How it works: The pacemaker sends electrical impulses to the heart to maintain a normal heart rate. It monitors your heart’s rhythm and activates only when needed. Types: Single-chamber pacemaker (usually for the right atrium or right ventricle) Dual-chamber pacemaker (coordinates activity between atrium and ventricle) Leadless pacemaker (a newer, miniaturized version placed directly into the heart) 2. ICD (Implantable Cardioverter Defibrillator) An ICD is a device designed to detect and treat life-threatening fast heart rhythms, such as ventricular tachycardia or ventricular fibrillation. When is it needed? History of sudden cardiac arrest High risk of ventricular arrhythmias (e.g., post-heart attack, low ejection fraction) Certain genetic arrhythmia syndromes (e.g., Long QT syndrome) How it works: The ICD continuously monitors the heart rhythm. When a dangerously fast rhythm is detected, it delivers an electric shock to restore normal rhythm (defibrillation). It may also perform anti-tachycardia pacing (ATP) to correct rhythm without shock. 3. CRT (Cardiac Resynchronization Therapy) CRT is used to improve the efficiency of a weak or failing heart by synchronizing the contractions of the left and right ventricles. When is it needed? Heart failure with reduced ejection fraction (HFrEF) Wide QRS complex on ECG (especially LBBB pattern) Persistent symptoms despite optimal medical therapy How it works: CRT devices use three leads—in the right atrium, right ventricle, and a coronary vein over the left ventricle—to coordinate heart contractions and improve cardiac output. Types: CRT-P (CRT with pacemaker function) CRT-D (CRT with defibrillator function)