A pacemaker is a small device placed under the skin below the collarbone, with thin leads to the heart. It treats a slow heartbeat or heart block that causes tiredness, dizziness or fainting. It is implanted under local anaesthetic at Kauvery Heart Institute, and most patients stay in hospital for 1 to 2 days. The type of pacemaker is chosen to suit your heart rhythm, and regular device checks are arranged after implantation to make sure it is working well. Cost on consultation.

Catheter ablation treats abnormal heart rhythms at their source. Thin wires are passed to the heart through a vein in the groin, the heart's electrical circuit is mapped, and the small area causing the abnormal rhythm is treated with radiofrequency energy. Done at Kauvery Heart Institute. It is commonly used for supraventricular tachycardia (SVT), atrial flutter and some ventricular rhythm problems. For SVT, success rates reported in published studies are high, and many patients no longer need long-term medicines. Most patients go home the next day. Cost on consultation.

Closing a hole in the heart without surgery, using a small umbrella-shaped device passed through a vein in the groin and guided by X-ray and echocardiography. Done at Kauvery Heart Institute. It is used for atrial septal defect (ASD), patent ductus arteriosus (PDA), selected ventricular septal defects (VSD), and a patent foramen ovale (PFO) in selected patients after a stroke. Most patients go home in 1 to 2 days and return to normal activity within about a week. Cost on consultation.

TAVI (transcatheter aortic valve implantation) replaces a narrowed aortic valve through the artery at the top of the leg, without open-heart surgery. Done at Kauvery Heart Institute, Radial Road. It is for people with severe aortic stenosis, most often those aged 70 or over or at higher risk from surgery, after assessment by a Heart Team of cardiologist and cardiac surgeon. Evaluation includes an echocardiogram, a TAVI CT scan and an angiogram. The procedure is usually done under local anaesthetic with light sedation, and the typical hospital stay is 2 to 3 days. Read more on our TAVI page. Cost on consultation.

Excimer laser coronary atherectomy uses pulses of laser light, delivered through a thin catheter, to break up tough plaque inside a heart artery. It is useful when a balloon cannot cross or open a blockage, in arteries that have been fully blocked for a long time, and in old stents that have narrowed again or never expanded fully because of calcium behind them. Laser is used as part of a planned complex angioplasty at Kauvery Heart Institute, often together with imaging inside the artery and other calcium tools. You stay awake under local anaesthetic and do not feel the laser. Cost on consultation.

An X-ray test that shows the heart arteries, using contrast dye injected through a thin tube, usually from the wrist. Done at Kauvery Heart Institute, Radial Road. It takes 15 to 30 minutes under local anaesthetic, and most patients go home the same day or the next morning. The angiogram shows whether the arteries are narrowed or blocked, and guides the choice between medicines, angioplasty and bypass surgery. If a significant blockage is found, angioplasty can often be done in the same sitting, after discussion with you and your family. Cost on consultation.

Opening narrowed or blocked heart arteries with a balloon and a drug-eluting stent, usually through the wrist and under local anaesthetic, at Kauvery Heart Institute, Radial Road. Complex angioplasty includes: - Heavily calcified (hard) blockages - Chronic total occlusions, where an artery has been fully blocked for months - Left main and bifurcation blockages - Patients who have been turned down for bypass surgery, or who do not wish to have it, because of age, a weak heart, lung or kidney disease, or a previous bypass Complex cases are planned in detail from the angiogram and treated with imaging inside the artery (IVUS or OCT) and calcium tools such as rotablation, laser and intravascular lithotripsy, so that the stent opens fully and lasts. When bypass surgery is the better option, we will tell you honestly. Read more on our Complex Angioplasty page. Cost on consultation.

A blood test done at the clinic, with the result available in minutes. NT-proBNP rises when the heart is under strain. It helps confirm or rule out heart failure as the cause of breathlessness or swelling, and during follow-up it helps the cardiologist adjust heart failure medicines. Fee: ₹1,000 (result in minutes).

A small recorder worn for 24 to 48 hours that records the heart rhythm during normal daily activity. It is used only when the cardiologist needs a longer rhythm recording after seeing you in clinic. Please note: Holter monitoring is prescribed only after a consultation with the cardiologist and is not booked as a stand-alone test. The recording is arranged through a partner diagnostic provider, and the cardiologist reviews the report with you.

Ultrasound scan of the heart with Doppler, performed by the cardiologist. An echo shows how strongly the heart pumps (ejection fraction), narrowing or leakage of the valves, thickness of the heart muscle, pressure in the lungs and holes in the heart. There is no radiation and no needles, and it takes about 20 to 30 minutes. It is used to assess breathlessness, heart murmurs and heart failure, after a heart attack, and before procedures such as TAVI and device closure. Fee: ₹1,500.

12-lead ECG done at the clinic and reported by the cardiologist during the same visit. It takes about five minutes and is painless. An ECG can show a current or old heart attack, abnormal rhythms, heart block and thickening of the heart muscle. It is usually the first test for chest pain, palpitations or breathlessness, and is also used to monitor the effect of heart medicines. Fee: ₹300 (reported by the cardiologist the same evening).

Evening consultation with Dr. Stalin Roy J, interventional cardiologist, at SR Heart Clinic, East Tambaram (Monday to Friday, 6:30 to 7:30 PM). See a cardiologist if you have: - Chest pain or tightness, especially on exertion - Breathlessness or swelling of the feet - Palpitations, dizziness or fainting - High blood pressure, diabetes or high cholesterol that needs a heart check - A family history of heart attack at a young age Second opinions: if you have been advised angioplasty or bypass surgery, you can bring your angiogram CD and reports. We review the images with you and explain the options. Please bring previous ECGs, echo and angiogram reports, discharge summaries and a list of your current medicines. Consultation fee: ₹500.