Angioplasty uses a tiny balloon to unblock a clogged artery
Hundreds of lives will be saved every year with the introduction of a "gold standard" treatment for heart attacks across England, say ministers.
A balloon and tube are used to unblock arteries and permit blood flow. A death rate cut from 7% to 5% is predicted, saving about 240 lives a year.
The government wants 97% of eligible heart attack patients to have a primary angioplasty within three years.
Currently 25% get the keyhole surgery, with the rest given clot-busting drugs.
About 25,000 people a year will be eligible for primary angioplasty, with the three-year target costing about £12m.
Although the treatment works out around £800 more expensive per patient than clot-busting drugs, it is cost-effective because it is better at preventing future problems such as another heart attack or a stroke, research shows.
In some areas of the country, including 10 pilot hospitals, primary angioplasty is already widely available.
Last year in London, only six patients were treated with traditional thrombolysis treatment to thin the blood.
For the treatment to work, it has to be done quickly. NHS research shows that patients need to have the procedure within two hours of having the heart attack.
But in areas such as Cumbria and East Anglia, carrying out primary angioplasty instead of thrombolysis within the key two-hour window will require much reorganisation of existing services.
It is envisaged that regional cardiac networks will have a rota of cardiologists working in a specialist centre around the clock.
Ambulance services will be expected to diagnose the problem and rush patients to the specialist centre, bypassing more local district general hospitals on the way.
Government heart tsar, Professor Roger Boyle, said: "It requires a lot of reorganisation of services - speed is of the essence.
"The paramedic makes the diagnosis and decides where to deliver the patient.
"They might have to pass a couple of hospitals they would normally go to but it's worth travelling a bit further to get the right treatment."
He added the NHS already had enough cardiologists to do the operations.
Similar schemes are being set up in Scotland and Wales, he said.
Dr Miles Dalby, consultant cardiologist at Harefield Hospital in north London, said patients who had thrombolysis often ended up having angioplasty a few days later anyway.
"It means the length of stay in hospital and recovery is dramatically reduced.
"As soon as the blockage is opened most patients have a dramatic improvement in their chest pain," he said.
As one of the pilot sites, Harefield has treated hundreds of patients this way, achieving an average of 23 minutes from arrival to treatment.
Professor Peter Weissberg, medical director of the British Heart Foundation, agreed primary angioplasty should be the "gold standard" treatment.
But he said: "The health service must ensure that sufficient resources are committed for this to occur.
"We must not replace a first-class thrombolysis service, which is proven to save lives, with a second-class angioplasty service which might not."