What are the benefits of IFR?

IFR is a non-invasive procedure that eliminates the need for injectable pressure-sensitive dye, reducing the risk of complications and allowing for a quicker and more comfortable patient experience. Also, the procedure of IFR interventional cardiology provides a more accurate assessment of the severity of stenosis compared to that of traditional angiography.

Who is a candidate for RFR?

RFR in cardiology stands for radiofrequency ablation, a minimally invasive procedure used to treat certain medical conditions. A candidate for RFR is typically someone who has a condition that can be treated with the procedure, such as: chronic pain, arthritis, cancer pain, tumors in the liver, lung or kidney, certain heart rhythm disorders such as atrial fibrillation.

What is an FFR procedure?

The FFR procedure (Fractional Flow Reserve) is a diagnostic tool used during coronary angiography to measure the blood flow and pressure differences across a narrowed section of a coronary artery. By assessing the significance of the narrowing, doctors can determine whether it impedes blood flow enough to require treatment like stenting or bypass surgery. The FFR cardiology procedure provides more precise information compared to traditional methods, ensuring interventions are necessary and optimizing patient outcomes.

What is the difference between angiogram and FFR?

An angiogram is a diagnostic test that visualizes the coronary arteries using X-rays and contrast dye to identify blockages or narrowing. While an angiogram provides a visual representation, it doesn’t quantify how severely the narrowing impacts blood flow. On the other hand, the FFR cardiology procedure measures the actual pressure drop across the narrowed artery, offering more detailed information on its functional significance. This helps in deciding whether stenting is required, unlike angiography which is more descriptive.

What is the cost of the FFR cardiology test?

The cost of FFR procedure can vary based on several factors, such as the hospital, the country, and whether additional diagnostic procedures like IFR interventional cardiology or RFR in cardiology are performed. In general, the procedure costs between $2,000 to $5,000 USD in countries like the U.S. and Europe, while in India, it can range from ₹1,50,000 to ₹2,50,000 INR. The price often includes the cost of the angiogram but may vary depending on the inclusions. Insurance may cover a portion of the cost.

100% Best FFR Cardiology Procedure | IFR and RFR Services

Q: What is Fractional Flow Reserve (FFR)?

FFR is a diagnostic procedure used in cardiology to measure the blood flow in coronary arteries and assess the severity of stenosis (narrowing of the arteries). The FFR cardiology procedure is performed by injecting a small amount of pressure-sensitive dye into the coronary artery and measuring the pressure drop as the dye moves through the stenosis.

Intracoronary physiology refers to the study of the functional status of coronary arteries within the heart. This is important for the diagnosis and management of coronary artery disease, which is a leading cause of death worldwide. There are three key intracoronary physiologic measures that are commonly used to assess the functional status of coronary arteries: FFR cardiology procedure, RFR, and IFR interventional cardiology.

Fractional Flow Reserve (FFR): FFR is a measure of the pressure difference across a stenotic (narrowed) coronary artery and is used to determine the functional significance of a lesion. The FFR cardiology procedure is calculated as the ratio of the mean distal pressure to the aortic pressure, and values less than 0.75 are considered to indicate ischemia (reduced blood flow to the heart).
Instantaneous Wave-Free Ratio (IFR): IFR is similar to FFR, but this IFR interventional cardiology is based on the assessment of blood flow during a specific period of the cardiac cycle (the wave-free period). The IFR provides a continuous measure of the functional significance of a stenotic lesion, with values less than 0.89 indicating ischemia.
Resting Flow Reserve (RFR): RFR is a measure of the ratio of coronary blood flow at rest to maximum blood flow achievable during hyperemia (induced increase in blood flow). RFR is used to assess the physiological significance of stenoses in patients with stable angina or in those undergoing cardiac stress testing.

What is Fractional Flow Reserve (FFR)?

Fractional Flow Reserve (FFR) is a specialized technique used in interventional cardiology to measure the pressure differences across a coronary artery narrowing (stenosis).
It helps doctors determine whether the narrowing significantly impairs blood flow to the heart and requires intervention.
FFR is performed using a catheter equipped with a pressure sensor during a coronary angiogram, providing real-time data to guide treatment decisions.
In modern interventional cardiology, FFR, IFR interventional cardiology, and RFR in cardiology are vital tools for precision-based heart care, minimizing unnecessary stenting or surgery.

FFR cardiology procedure | Dr. M. Kathiresan

When Would Fractional Flow Reserve be Needed?

Fractional Flow Reserve is typically used when coronary angiography reveals narrowed arteries, but it’s unclear if the stenosis restricts blood flow enough to cause symptoms or warrant intervention. By calculating the FFR, cardiologists can determine whether the artery’s blockage impairs blood flow, thereby guiding decisions about the necessity of stenting or bypass surgery. This assessment of functional significance in coronary stenosis helps cardiologists ensure effective, targeted treatment, enhancing patient outcomes in cardiology by addressing critical needs.

Diagnosis of FFR cardiology procedure

The diagnosis of intracoronary physiology involves the measurement of Fractional Flow Reserve (FFR), Instantaneous Wave-Free Ratio (IFR), and Resting Flow Reserve (RFR) in patients with suspected or known coronary artery disease.
The diagnosis of intracoronary physiology is used to determine the functional significance of stenoses (narrowings) in the coronary arteries, which can cause reduced blood flow to the heart and contribute to the development of chest pain (angina) or heart attacks.

Treatment

Before the FFR cardiology procedure, the patient will undergo a pre-procedural evaluation to assess their medical history, symptoms, and overall health. The patient may be asked to fast for a period of time prior to the procedure and to inform the healthcare team of any allergies or medications they are taking.

Then, a local anaesthetic is applied to the skin over the groin or wrist, and a small incision is made to access the femoral or radial artery. A catheter is passed through the incision and into the coronary arteries. The catheter is equipped with sensors and a pressure wire to measure blood pressure and flow within the coronary arteries.

Measuring (FFR): The pressure wire is used to measure the pressure difference across a stenosis (narrowing) in the coronary artery for the FFR cardiology procedure. The pressure difference is then used to calculate FFR, which provides information on the functional significance of the stenosis.
Measuring (IFR): The catheter is used for IFR interventional cardiology to measure blood flow during a specific period of the cardiac cycle (the diastolic phase), which is used to calculate IFR. IFR provides information on the severity of stenoses and their impact on blood flow.
Measuring (RFR): The catheter used during the RFR in cardiology procedure measures resting blood flow in the coronary artery and to measure maximum blood flow achievable during hyperaemia (induced by the administration of adenosine or papaverine). The ratio of resting blood flow to maximum blood flow is then used to calculate RFR, which provides information on the ability of the coronary vasculature to respond to increases in blood flow.

After the procedure, the patient will be taken to a recovery area for monitoring. The results of the intracoronary physiology measures of FFR, RFR, and IFR interventional cardiology will be reviewed, and the healthcare team will use the information to determine the best course of treatment for the patient.

What to Expect During the Procedure

The FFR cardiology procedure is minimally invasive and typically performed in a catheterization lab.
You’ll be awake but sedated for comfort. After numbing the access site (usually in the wrist or groin), the cardiologist inserts a catheter into the artery.
A guidewire with a pressure sensor is passed through the narrowed artery, and a small amount of adenosine (or other medications) is injected to simulate stress on the heart.
The doctor measures the pressure before and after the narrowing to calculate the fractional flow reserve.
It can be performed alongside IFR interventional cardiology or RFR in cardiology to get a complete picture of your coronary health.

What to Expect After the Procedure

After the FFR cardiology procedure, patients are monitored in recovery for a few hours.
You might feel mild discomfort or soreness at the access site, but this typically resolves quickly.
Depending on the results, your doctor may recommend stenting, medication, or lifestyle changes.
Most patients can return to normal activities within a day or two.
The cost of FFR procedure varies based on factors like location, hospital, and insurance, but it generally ranges between $2,000 to $5,000 USD or ₹1,50,000 to ₹2,50,000 INR.

Benefits

The benefits of the FFR, IFR, and RFR in cardiology include the following:

Improved diagnostic accuracy.
Better patient outcomes.
Reduced exposure to radiation.
Cost-effectiveness.

Risks

There are also potential risks associated with intracoronary physiology measures. These include,

Bleeding or infection at the site of access after the FFR cardiology procedure.
Allergic reactions to contrast dyes or medications.
Rare but serious complications such as cardiac arrhythmias or heart attacks.

What are the Side Effects of a FFR Procedure?

Though FFR is generally safe, some side effects may occur. These include minor risks such as bleeding or bruising at the catheter insertion site, arrhythmia, or chest discomfort. Rarely, allergic reactions to contrast dye or complications from catheter insertion may arise. However, advances like using RFR in cardiology have further improved procedural safety. Cardiologists carefully evaluate risks and benefits, ensuring this minimally invasive procedure remains a safe option for evaluating coronary artery disease in patients.

Facilities

The technology and facilities used for intracoronary physiology, especially for the FFR, IFR, and RFR in cardiology, including

Diagnostic coronary angiography.
Pressure and flow measurement devices.
Cardiac catheterization laboratories.

Our Doctor

Dr. M. Kathiresan will discuss the potential benefits and risks of the procedures relating to FFR, IFR, and RFR in cardiology with the patient and provide informed consent. Additionally, he will monitor the patient during and after the procedure and provide any necessary post-procedural care.

Conclusion

The FFR cardiology procedure is a breakthrough in cardiac care, providing precise data to guide treatment decisions for coronary artery disease. When combined with IFR interventional cardiology or RFR in cardiology, it ensures that interventions like stenting are truly necessary. Understanding the cost of FFR procedure can help patients plan ahead, and the procedure offers a minimally invasive way to achieve better heart health outcomes.

Intracoronary Physiology – FFR, IFR, RFR