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Procedures
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Interventional:
Diagnostic
Cardiac Catheterization
Coronary
Balloon Angioplasty
Peripheral
Angioplasty
Coronary
Stent Placement
Rotoblater
and Atherectomies
Permanent
Pacemakers
Defibrillator
Implantation
Electrophysiologic
Investigation
AICD
(Automatic Implantable Cardioverter Defibrillator)
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Outpatient:
Treadmill
Testing
Electrocardiogram
(EKG and ECG)
24-Hour
Holter Monitoring
Echocardiography
(both Transthoracic and Transesophageal)
Pacemaker
and Defibrillator Checkups
A
Fully-Equipped Laboratory
High-Complexity
Diagnostics
Nuclear
Cardiology
Cardioversion
Event
Recording and Assessment of Rhythm Disturbances
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Diagnostic Cardiac Catheterization
A diagnostic cardiac
Catheterization, also called coronary angiography or heart catheterization,
is a procedure that provides detailed information about the function
of the heart and its arteries. By combining that information from
blood tests and other diagnostic tests with a cardiac catheterization
procedure, your doctor can accurately diagnose a heart condition
and the most effective treatment plan.
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Coronary Balloon Angioplasty
Percutaneous transluminal
coronary angioplasty (PTCA), or balloon angioplasty, is a procedure
used to open narrowed coronary arteries. It is performed with
a local anesthesia while the patient is awake. Patients whose
angina has not been relieved by medications are generally the
best candidates for PTCA. There are several other commonly used
treatments for opening blocked arteries such as the Rotoblator
procedure (tiny rotating blades) or Atherectomies (cutters) to
cut away plaque buildup on the artery walls, or Stents (a little
metal "scaffold") that widens obstructed arteries.
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Peripheral Angioplasty
Peripheral angioplasty
is performed much like that of PCTA or percutaneous transluminal
coronary angioplasty, but to open blocked arteries or remove blood
clots in the patient's legs.
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Coronary Stent Placement
The Stent is a stainless
steel device (scaffold) which compresses the plaque, much like
in the coronary balloon angioplasty procedure. It is implanted
by guiding a thin, balloon-tipped catheter through the artery
to the blockage. The collapsed stent is part of the catheter tip,
and when the balloon is inflated the stent expands into place
allowing the flow of blood once again through the coronary arteries.
After a couple of weeks tissue forms around the stent and it becomes
a permanent support for the artery.
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Rotoblater and Atherectomies
The rotoblator is a
procedure used to clear blocked arteries. Your doctor guides a
thin catheter through the artery to the blocked area. The catheter
contains a small, specially designed, rotating blade which chips
off hard plaque buildup on the artery walls. The chips of plaque
are then small enough to be absorbed and expelled into the blood
stream. The atherectomy procedure is similar however it contains
a cutter which shaves the plaque away from the artery wall. The
plaque is then removed through the catheter. Both procedures are
used to effectively clear blocked arteries.
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Permanent Pacemakers
A pacemaker
is a battery-operated device that helps maintain a normal heart
rhythm. It sends electrical signals to the heart to stimulate
contracting or pumping of the heart muscle. It is designed specifically
for patients who have irregular or very slow heart rates and symptoms
of fainting or fatigue.The rate is set by the doctor. The pacemaker
generator is placed under the skin on the chest wall below the
collarbone. It contains a battery and wires(leads) which are positioned
inside the heart and transmit the signal from the battery to the
heart thus causing the contracting.
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Defibrillator Implantation
An implantable cardiovertor
defibrillator system or implantable cardiac devices (ICD), is
a small electronic device that monitors heart rhythm and delivers
a shock to correct a potentially fatal heart rhythm if it should
occur. The generator is surgically implanted beneath the skin
and muscle beneath the collarbone. Wire electrodes attach the
pulse generator to the heart. Some of the wires are inserted through
veins into the inside of the heart and can sense the heartbeat.
Other wires may be attached directly to the heart. These wires
are used to deliver the shock, if necessary, which converts the
heart back to its normal rhythm.
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Electrophysiologic Investigation
Electrophysiology testing
makes it possible to study heart rhythm disturbances under controlled
conditions. By using special insulated wires called catheters,
your doctor is able to identify the rhythm disturbance and choose
the best treatment method. The procedure is performed in the cath
lab. It involves inserting thin plastic catheters into the large
blood vessels in your groin and arm, then guiding them to the
heart with the help of a special X-ray machine. When the catheters
are in place in your heart, a doctor who specializes in electrophysiology
will stimulate the heart artificially with electrical impulses
delivered through the catheters. Your doctor will watch the heart's
reaction to determine the extent of rhythm disturbance.
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AICD (Automatic Implantable Cardioverter Defibrillator)
An AICD is a computerized
device implanted in the abdominal wall. It detects and generates
electrical impulses through leads placed on or in the heart that
sense a cardiac disturbance such as the onset of a recurrent heart
attack or heart failure (tachycardia or fibrillation). The primary
purpose of the AICD is to deliver a counter-shock to the heart
in order to stabilize and resuscitate the patient's normal heart
rhythm.
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Treadmill Testing
Commonly referred to
as the Stress Test, Treadmill Testing takes about 45 minutes and
evaluates the heart's response to increased activity. It is used
in several ways to diagnose coronary artery disease, to monitor
the progress of your treatment or as part of a routine physical
exam.
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Electrocardiogram (EKG and ECG)
The EKG records the
heart's electrical activity to detect abnormal heartbeats (rhythmias).
It can even show a heart attack in progress.
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24-Hour Holter Monitoring
The Holter monitor
is used in diagnosing heart rhythm disturbances that may occur
at times when you are away from the doctor. It is used in conjunction
with a written diary or log of your daily events and activities.
The Holter monitor allows doctors to relate those symptoms to
actual variations in heart rhythms, providing them with further
diagnostic information for determining the most course of treatment.
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Echocardiography (both Transthoracic and Transesophageal)
This test uses ultrasound-high
frequency sound waves-to create a videotape of the heart's chambers,
valves, wall motion, and blood flow patterns. This can be done
by applying the ultrasound probe to the chest wall or by passing
the probe down the patient's throat in order to image the patient's
heart from inside the chest (transesophageal).
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Pacemaker and Defibrillator Checkups
The heart is required
to maintain a fast enough heartbeat and rhythm to keep blood flowing
throughout the body. Pacemakers and Defibrillators are devices
sometimes implanted in the body to keep the heart beating properly.
Period checkups are required of these devices.
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A Fully-Equipped Laboratory
The lab is fully-equipped
to take chest X-rays to determine the size of the heart and condition
of the lungs, cardiac enzyme counts to determine if heart muscle
is damaged, cholesterol, triglyceride, and/or glucose (blood sugar)
levels to help identify risk factors for heart disease, and blood
samples for further diagnosis.
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High-Complexity Diagnostics
A common high-complexity
outpatient diagnostic test is cardiac catheterization, also called
coronary angiography or heart catheterization. These procedures
provide more detailed information about the function of the heart
and its arteries than other diagnostic tests. However, by combining
information from blood and other diagnostic tests with a cardiac
cath procedure, your doctor can more accurately diagnose a heart
condition and prescribe the most effective treatment plan.
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Nuclear Cardiology
Using a high resolution
detector-camera in conjunction with a pharmacologic radionuclide
and treadmill test, your doctor can perform four different nuclear
cardiology studies of the heart.
1. Cardiac Blood Pool Imaging, also known as a MUGA, to evaluate
the left and right ventricul function including wall motion and
blood ejection fraction.
2. A Myocardial Perfusion test can assess coronary artery disease
utilizing the treadmill and pharcologic agent.
3. Radionuclide Angiocardiography to assess right ventricular
ejection fraction, and
4. Shunt Evaluation to assess abnormal intracardiac communications.
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Cardioversion
With the patient sedated,
pads are applied to the chest and an electrical impluse is delivered
to correct some types of abnormal heart rhythm. Event Recording
and Assessment of Rhythm Disturbances Event recording is often
necessary when the normal pacing of the heart is disturbed. There
are several treatments which help in the assessment of a rhythm
disturbance. They are: Electrocardiogram or 24 Hour Holter Monitoring
which records the heart rate in the doctor's office or while you
go about your daily activities, or an echocardiogram whereby images
are made of the heart through sound waves otherwise known as ultrasound.
In some cases it may also be necessary to stimulate the heart
through electrical Cardioversion to in order to restore normal
rhythm.
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Event Recording and Assessment of Rhythm Disturbances
Event recording is
often necessary when the normal pacing of the heart is disturbed.
There are several treatments which help in the assessment of a
rhythm disturbance. They are: Electrocardiogram or 24 Hour Holter
Monitoring which records the heart rate in the doctor's office
or while you go about your daily activities, or an echocardiogram
whereby images are made of the heart through sound waves otherwise
known as ultrasound. In some cases it may also be necessary to
stimulate the heart through electrical Cardioversion to in order
to restore normal rhythm.
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Copyright ©2001 by Heart & Vascular Center
of Arizona - ALL RIGHTS RESERVED
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