Ablation – This is a procedure used for treating abnormal heart rhythms with catheters that are placed in the heart through a vessel in the groin/leg. Once the location and source of extra beats or fast rhythms is located with an EP study, it can be stopped by a catheter heating across part of the short circuit or focus of extra beats with energy to restore a healthy heart rhythm. It can be used on abnormal rhythms from the top chambers of the heart like atrial fibrillation, atrial flutter, AV nodal reentrant tachycardia, AV reentrant tachycardia, atrial tachycardia, or abnormal rhythms from the bottom chambers of the heart, like ventricular tachycardia or frequent PVCs or extra beats.
Ankle brachial pressure index (ABPI/ABI) – This is a method of calculating the blood pressure in your legs. Your physician can calculate your ABI with a painless exam. The test will compare the blood pressure in your feet to the blood pressure in your arms. If the pressure in your legs is lower than in the arms, it indicates narrowing or blockage in the leg arteries, also known as peripheral artery disease (PAD).
Segmental pressures – This non-invasive test is similar to ABI and measures the blood pressure in your legs to make sure there is normal blood flow. Blood pressure measurements are made at different locations on the legs to localize which arteries have blockage. Typically, the blood pressure in the legs is similar to blood pressure in the arms. Lower pressure in the legs usually means there is plaque or blockage in the leg arteries.
Arterial duplex scan – Arterial duplex scan is a non-invasive exam that uses high-frequency sound waves (ultrasound) to capture internal images of the major arteries in the arms, legs, and neck. A gel is placed on the area being examined while a transducer is pressed lightly over the skin above the artery. Images of arteries are displayed on a monitor and can be recorded digitally and then can be interpreted by the physician. This is useful in detecting peripheral artery disease (PAD) and assessing its severity to guide treatment.
Biventricular Device – This is a special kind of pacemaker or defibrillator (ICD) that allows the ability to synchronize the heart and restore a more normal contraction pattern to the heart beat. In some conditions, the hearts contractions or squeezing is not in sync or together, which can cause worsening symptoms such as shortness of breath and fatigue. This kind of device can potentially fix that problem by allowing the heart to beat without a delay in contractions. It is done by adding an extra wire to a pacemaker or ICD that is placed near the left side of the heart to allow the walls to beat together.
Cardioversion – This is a procedure to treat abnormal rhythms that are irregular or too fast. After being sedated, a very short and controlled electrical shock is delivered to the heart to convert it back to a normal rhythm. It is commonly used for rhythms like atrial fibrillation or atrial flutter.
Carotid ultrasound – Carotid ultrasound is a non-invasive exam that uses high-frequency sound waves to capture images of the carotid arteries, the large arteries on each side of your neck. The carotid ultrasound shows blood flow in the neck arteries that supply blood to the brain. The carotid ultrasound can show plaque buildup in your carotid arteries and help detect carotid artery disease.
Coronary stenting – Coronary stenting is a treatment for coronary artery disease (CAD). It is a procedure done after a diagnostic heart catheterization, to open clogged heart arteries without need for open heart surgery. A stent helps hold open a blocked or clogged heart artery so that blood can flow through it. A stent is a small, wire mesh tube that is wrapped over a collapsed balloon. It is delivered inside the clogged heart artery via a tube or catheter inserted from the groin or arm. Once inside the artery the balloon is inflated to break up the the blockage and prop open the stent. The stent lines the inside of the artery and remains permanently in place to keep it open. This procedure is performed in a cardiovascular catheterization laboratory with local anesthesia. An IV (intravenous line) in your arm or hand will provide you with medication to make the procedure comfortable.
Defibrillator (ICD) – This is an implantable device placed under your skin in your chest that is able to monitor the heart for any bad or deadly rhythms and provides therapy with extra beats or a shock to stop bad rhythms and save your life. It has wires that are attached to the device that are placed inside your heart. People with weak heart muscles, prior heart attacks and some genetic abnormalities are at risk for these dangerous rhythms. ICDs also have the ability to pace the heart if needed.
Diagnostic cardiac catheterization – Cardiac catheterization or coronary angiography is a specialized exam used to look inside the arteries and chambers of the heart. Catheterization is a nonsurgical, minimally invasive procedure that provide your doctor with information about how your heart is functioning. Cardiac catheterization helps diagnose and treat heart conditions, such as coronary artery disease, defective heart valves, or congenital heart defects (defects you are born with). Coronary angiography uses X-ray and contrast (dye) to capture images of the coronary arteries, the arteries that bring blood to the heart. To inject the contrast (dye) into the blood stream, a catheter is inserted into a blood vessel in the upper thigh (groin) or arm and passed through to the coronary artery or heart. Once the catheter is in place, the contrast (dye) is released and images called coronary angiograms are taken. The coronary angiograms can indicate the buildup of plaque on the inside walls of the coronary arteries and can help detect coronary artery disease (CAD). This procedure is performed in a cardiovascular catheterization laboratory with sedation. An IV (intravenous line) in your arm or hand will provide you with medication to make the procedure as comfortable as possible. If significant blockages are found, coronary stenting may be required.
Electrocardiogram (ECG) – An electrocardiogram, better known as an EKG or ECG, is a noninvasive diagnostic test that uses electrodes to record the electrical activity of the heart. It can assist in diagnosing a number of heart conditions, including heart attack and abnormal heart rhythms. Even when there is no suspicion of heart disease, an EKG is often part of a general physical examination and health screening.
Electrophysiology Study (EP Study) – This is a study that tests the electrical system of the heart for problems. It allows the identification and location of irregular heart beats or short-circuits in the heart. The procedure involves placing several IVs in veins in the groin/legs, which allow catheters to be placed in the heart in specific areas to measure and study the hearts electrical activity. Rhythms from the top part of the heart (atrium) and the bottom part (ventricles) can be induced, tested and then localized. If found, they then can be terminated with an ablation procedure.
Exercise stress test – A stress test helps determine how the heart functions during exercise. It is helpful in diagnosis and treatment of coronary artery disease, congestive heart failure, and heart rhythm problems. During this test you walk briskly on a treadmill while your heart rate, blood pressure, and EKG are monitored.
Echocardiogram – An echocardiogram is a non-invasive test that uses sound waves, ultrasound, to produce images of your heart, showing its size, structure, and function. It provides valuable information about your heart health and can determine the presence of many types of heart disease. An echocardiogram is often combined with a Doppler ultrasound, which is able to capture images of how blood moves through your heart. This helps to determine how the blood is flowing between the chambers and valves of the heart. An echocardiogram helps to detect coronary artery disease, congenital heart disease, heart failure, and heart valve diseases.
Stress echocardiogram – A stress test helps determine how the heart functions during exercise to diagnose coronary artery disease and heart-related conditions and to examine the effectiveness of treatment. While exercising on a treadmill, your heart rate, blood pressure, and EKG are monitored. An echocardiogram or ultrasound exam of the heart is performed before exercise and immediately after exercise. Comparing heart function before and after exercise helps your physician diagonse and treat coronary artery disease.
Event Monitor – Thirty-day cardiac event monitoring — also known as ambulatory electrocardiography (EKG) — it uses a battery-operated portable device that is similar to a Holter monitor to measure and record the heart’s electrical activity. The monitor is worn during daily activities and while you sleep. It is very helpful for patients with palpitations, dizziness and if there is a concern for fast or slow rhythms. Several leads are placed onto your chest and connected to the small device you wear and can record when you push a button. It allows the heart’s electrical activity to be recorded intermittently during a period of 30 days. Event monitoring may be performed to help diagnose abnormal heart rhythms (arrhythmias) or silent myocardial ischemia (a condition where the heart is not receiving enough oxygen-rich blood).
Holter Monitors – These monitors are battery-operated portable devices that measures and records the heart’s electrical activity. They are worn during daily activities, including when you sleep. It allows the heart’s electrical activity to be recorded longer than an electrocardiography (EKG) test. Holter monitoring can be conducted continuously for 24 to 48 hours, and can transmit the information to us to assess. Is very helpful for patients with palpitations, dizziness and if there is a concern for fast or slow rhythms. Several leads are placed onto your chest and connected to the small device you wear. It may be performed to help diagnose abnormal heart rhythms (arrhythmias) or silent myocardial ischemia (a condition where the heart is not receiving enough oxygen-rich blood).
Implantable Loop Recorder – This is a very small device (with no wires needed) placed under the skin in the chest, that also has the ability to monitor the heart rate and rhythms for abnormal activity. These are similar to a holter or event monitors in that they record the heart’s electrical activity, but are able to record for much longer periods of time – up to 3 years, for less frequent symptoms of palpitations or dizziness or passing out. It is able to transmit wirelessly the information to us to assess and evaluated.
Nuclear perfusion imaging – Nuclear perfusion imaging is a commonly test to measure blood flow in the heart and helps in diagnosis and monitoring of coronary artery disease. First, a radioactive dye is injectied via an IV in your arm while at rest. Pictures of your heart are taken using a special camera. Then you undergo a stress test either using treadmill exercise or a medication. After the stress test, a second injection of the dye is administered, and a second set of pictures taken of your heart. Comparing blood flow at rest and after stress in different parts of the heart muscle allows your physician to diagnose coronary artery disease, determine if there is any damage to your heart muscle from prior heart attack, and decide on further treatment.
Pacemaker – This is an implantable device that is placed under the skin in chest that is able to monitor your heart beats and provide extra beats if your heart is too slow or has pauses. Wires are attached to this device that are placed in specific areas or chambers of your heart. It helps control some of these abnormal heart rhythms. A pacemaker can help with symptoms of fatigue and passing out.
Tilt Table Test – This is a test that is able to evaluate for specific causes of why people pass out or have syncope, called vasovagal syncope, or neurocardiogenic syncope. It can help guide treatment options, and involves evaluating the cardiovascular response to standing upright for a period of time. It involves being tilted upright around 60 to 70 degrees on a secure table, and then being monitored for symptoms or significant changes in blood pressure and heart rate. If no changes have occurred after a period of time, a dose of medicine can be given followed by further observation.