EKG, and Exercise/Treadmill EKG Electrocardiography is commonly referred to as EKG or ECG. A doctor may order an EKG to diagnose heart rhythm or heart structure problems, or a heart attack. The ECG procedure lasts 30 - 60 seconds and is accomplished by attaching 12 - 15 electrodes to the skin on your arms, legs, chest and/or back. A Treadmill EKG lasts approximately 30 minutes and includes monitoring blood pressure and assessment of exercise capacity. This test is important to perform when someone wishes to start a vigorous exercise program.

Echocardiography An Echo test uses sound waves to provide information about the heart. An Echo is a non-invasive test using a small probe held near the chest to produce ultrasound waves. A computerized heart image shows the muscle function, valve function and blood flow. This test provides information regarding the anatomy of the heart. The procedure takes about 15 - 30 minutes.

Vascular Ultrasound Testing Sound waves are used to evaluate the carotid arteries, the lower extremity arteries or the lower extremity veins. These procedures take about 30 - 45 minutes each.

Stress Echo A stress echo test requires the patient to exercise on a treadmill to evaluate the heart muscle before and after exercise. A similar heart rate elevation may be induced by medication and is used for people who are not able to exercise.

Transesophageal Echocardiography Transesophageal echo tests are used when the echocardiogram tests described above cannot provide adequate information. The procedure involves numbing the throat and then inserting a tube down the throat to the esophagus to view the heart.

Nuclear Cardiac Imaging Nuclear scans are used to look at heart size, heart blood circulation and heart muscle scarring. Nuclear scans work by injecting a small amount of a radioactive solution into the blood and then tracing the radiation via a camera and computer to view blood flow to the heart muscle.

Holter Monitoring Holter monitoring is a continuous, 24 hour EKG reading used for patients with fast heart rates, dizziness and shortness of breath. The patient takes home a recorder, connected via wired patches, which reads heart rate and rhythm. The patient also keeps a diary to correlate symptoms and heart activity. When the patient returns to the office, a technician using a computerized scanner reads the recording.

Event Monitoring Event monitoring is a transtelephonic monitoring service that is used to diagnose symptoms that are infrequent or sporadic. The monitor is worn over a period of thirty days to monitor heart rhythm and to record symptoms such as irregular heart rate.

Cardiac Catheterization Cardiac Catheterization is used to evaluate the blood flow through the arteries on the heart, the heart valves and the strength of the heart muscle. Catheters are also used to biopsy the heart. The catheterization procedure takes about 30 minutes and involves inserting a long, thin tube into the artery or vein in the groin. The thin tube is guided to the heart and a dye is infused into the arteries and heart chambers. Pictures are taken with a special camera/computer.

Electrophysiology Electrophysiology uses catheters (tubes or wires) inserted into the heart chambers to test electrical impulses in the heart and create a map of the heart's activity. The procedure is done in sterile conditions under the supervision of a cardiologist and other medical personnel. The test may take 30 minutes to 4 hours.

Coronary Angioplasty Coronary angioplasty uses a balloon tipped catheter to open a blocked artery by squeezing the blockage against the artery wall. The balloon tipped catheter is inserted the same way as described under cardiac catheterization. The procedure takes about 1 - 3 hours and may require an overnight hospital stay.

Coronary Atherectomy A coronary atherectomy uses a catheter to remove blockage from the artery and open blockages. This catheter is equipped with special blades that scrape the blockage from the artery and removes it either through suction or by packing it into the tip of the catheter. The procedure may take 1 - 3 hours and may require an overnight hospital stay.

Rotablator The Coronary Rotablator procedure uses a tiny rotating football-shaped tip to shave a blockage from an artery. The particles shaved off are smaller than red blood cells and will flow downstream. The procedure may take 1 - 3 hours and may require hospitalization.

Pacemaker and Pacemaker Monitoring A pacemaker is surgically inserted to treat a slow heartbeat. The pacemaker uses electrical impulses to stimulate the heart as needed. Patients with pacemakers require careful regular followup to ensure a proper function. This is achieved in our office pacemaker clinics and over the phone. Office checks are recommended every six months and transtelephonic every two months. Information about living with a pacemaker is available at CDS.

Implantable Cardioverter Defibrillators (ICD) The ICD is surgically inserted to treat fast irregular heartbeats that could be life threatening. The device corrects the irregular heartbeat by pacing the heart or delivering a small electrical shock to the heart. The use of ICDs has been shown to be the most successful form of treatment for life threatening irregular heart rhythms. Patients are required to follow up in the office for regular checks of their ICD and its function. Information about living with ICD and support groups is available.

Coronary Stent A Coronary Stent is inserted into an artery to hold open previously blocked arteries. The procedure is identical to the balloon angioplasty. The stent looks like a small wire frame made of stainless steel. It is mounted on a coronary balloon that is inflated to high pressures up to one minute. This expands the stent and firmly implants it into the artery wall. It will remain in the artery forever.

Ablation Therapy Ablation therapy is used to treat cardiac rhythm disorders such as rapid heart rates. The procedure uses a catheter heated with radiofrequency energy to the precise area of heart tissue. This disrupts the pathway and stops the rapid heartbeat. Successful ablation may prevent the need to take medication in the future.