Cardioversion

Cardioversion is the delivery of an electric shock to the heart in order to restore normal rhythm to the heart.  The procedure requires that the patient be sedated. The doctor then delivers an electric shock to the heart via paddles on the patient's chest.  This momentarily stops the electrical activity of the heart, allowing it toreturn to a normal rhythm. Normal rhythm is usually restored, but occasionally the procedure needs to be repeated several times. The patient is monitored closely throughout the procedure and afterward. The sedation usually wears off quickly and the patient will recover prior to going home.However, due to possible mild lingering effects of anesthesia, the patient should not drive or use heavy machinery for the remainder of the day.

Electrocardiogram

An electrocardiogram is a recording of electric waves generated by the heart. It is used to measure the rate and regularity of the heart's rhythms. The procedure is simple, routine, painless, and only requires a few minutes.

 24 Hour Holter Monitoring

 Hour Holter Monitoring is an electrocardiogram  recorded on tape  continuously for 24 hours by utilizing a small, portable machine. Small pads are placed on the skin overlying the heart. Wires connect the pads to a small recorder. The patient records activities and symptoms in a diary. Holter monitoring is useful in ascertaining the cause of fainting, light headedness, palpitations, some cases of chest pains, and in the follow-up of medications that regulate heart rhythm. The procedure is painless.

 Event Monitoring

Event monitoring utilizes a small, portable, battery-powered machine used by a patient to record an electrocardiogram over a long period of time. Patients may keep the recorder for several weeks. Each time symptoms are experienced, the patient presses a button on the recorder to record the EKG sample. As soon as possible, this sample is transmitted to the doctor's office by telephone hookup for evaluation. The procedure is painless.

Exercise Tolerance Test (Stress Test)

Treadmill exercise testing helps in the evaluation of individuals with chest pain and other symptoms caused by physical exertion and in the follow-up of patients treated for hardening of the arteries with such procedures as  angioplasty, stenting or bypass surgery. Electrocardiogram and vital signs are continuously monitored while the patient exercises on the treadmill. The procedure is simple and safe. Exercise is stopped when the patient reaches target heart rate, develops shortness of breath, chest pain, fatigue, or the electrocardiogram reveals abnormal findings. The patient's condition is carefully monitored throughout the test to assure safety.

 Pharmacologic Stress Testing

 When a treadmill exercise test is impossible or difficult to obtain or the study is incomplete, the heart can be stressed by the infusion of medications. The electrocardiogram and vital signs are monitored in the same way as during the treadmill test.

Echocardiography

Echocardiography is a procedure that uses ultrasound waves to create  images of the heart. Sonar waves are directed through the heart via a probe placed on the chest. Reflected sound waves are harnessed to  produce heart images. The procedure takes approximately 20 minutes to complete. The images are analyzed to assess how the heart functions as a pump, the integrity of the heart valves, and whether there are tumors, defects, or clots inside the heart or fluid outside the heart. Combined with a stress test, echocardiography can provide valuable information about the likelihood of hardening of the coronary arteries.

Nuclear Imaging

Nuclear imaging is a procedure that uses very small amounts of radioactive materials along with a specialized camera and computer to provide precise pictures of the heart and arteries that can detect blockages of arteries and assess heart function. 

Pacemaker-ICD Evaluation & Programming

A special device is used to check, and, if necessary, reprogram the pacemaker. The procedure is simple and similar  to obtaining an electrocardiogram. Patients with artificial pacemakers and implantable defibrillators (ICDs)  need to be evaluated  in the office at intervals that are determined by the patient's medical condition and age of device.

Tilt Table Testing

The tilt table test is used in the evaluation of dizziness and fainting spells. It is designed to evaluate the function of the patient's blood pressure sensors and ability to maintain normal blood pressure in response to change in position. During this simple examination, the patient strapped to the table, an IV is started and baseline EKG and blood pressure is recorded. After about ten minutes, the table is tilted to 80 degrees. The EKG and blood pressure continue to be monitored throughout the test. If you faint during the test you will be returned to a horizontal position and you will be closely monitored during your recovery period. monitoring.

Vascular Studies

• Ankle-Brachial Index: ABI is a measurement of blood pressure at the ankle and arm at rest and after five minutes of exercise. After the recording of the results and careful calculations, the doctor can predict the presence and severity of peripheral vascular disease.
• Abdominal Ultrasound: An imaging procedure that uses ultrasound to evaluate for the presence of an abdominal aortic aneurysm, which is a weakening in the wall of the aorta. This weakening can cause rupture and possible death.
• Carotid Duplex Study: An imaging procedure that uses ultrasound to view the blood vessels in the neck and to determine the presence of narrowing in the carotid arteries. Like the arteries that supply blood to the heart, the carotid arteries can also develop of plaque. Over time, the plaque can narrow the artery, decrease blood flow to the brain and lead to a stroke.
• Upper and Lower extremity Doppler: A test that views the veins in the arms or legs from different angles. The doppler is pressed into the skin every few inches to detect any change in the shape of the veins under pressure. This test will determine if there are blockages which can break loose and travel to the lungs, a condition that may be dangerous or life threatening.
• Lower extremity arterial Study: A measurement that assesses blood flow through the arteries. Blood pressure cuffs are placed in several locations and inflated two times. The firs time, the cuff is inflated half way, exerting gentle pressure on the leg and sends information to a computer, which can be viewed on a screen.  The second time, the cuff is completely inflated, temporarily cutting off circulation to the leg.  As the cuff deflates, the technician places the Doppler against the foot and determines the moment blood flow starts again and measures leg blood pressure. Blood pressure is also taken in the arms to compare values. This test can determine whether or not there is narrowing in the arteries.
• Mesenteric Vascular Exam: A test to determine the presence or absence of a stenosis, aneurysm of the mesenteric arteries. This test is done after patient has fasted from the evening before and is usually done in the early morning.