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CARDIAC - Diagnostic And Treatment Procedures

The invasive and non-invasive procedures available through Guthrie’s Section of Cardiology incorporate established and emerging technologies to provide accurate diagnosis and treatment. Our staff consists of board-certified physicians, technicians and nurses.

Non-Invasive Diagnostic Cardiology

Click the following links to learn more about each procedure using our new "interactive body" player!
Interactive Body  Angioplasty
 Cardiac Cath
 Stent Placement

You will need the Flash plug-in to view the animations. You can get the free plug-in by clicking here.

Invasive/Interventional Cardiology Treatments

 

Diagnosis

The following procedures are often used in the evaluation of cardiovascular disease. Consult your Guthrie physician or health care provider for more specific information.

Cardiac Catheterization is a method of diagnosing and treating coronary artery disease. The procedure involves having a catheter (thin tube) inserted through an artery in a leg or an arm to the heart under X-ray guidance to visualize the chambers of the heart and the coronary arteries. Cardiac catheterization is used in conjunction with other tests such as angiography (injecting dye to visualize heart and coronary arteries) and electrophysiology studies (studying how the heart responds to controlled electrical impulses). For more information, click here.

Dobutamine Stress Echocardiogram (Dobutamine Myocardial Viability Study) is a test that uses sound waves (ultrasound) and a medication called dobutamine to examine the functioning of the heart. This test is used when a patient is unable to increase their heart rate through exercise, so medication increases the heart rate to simulate exercise. Dobutamine increases heart rate and blood pressure much like exercise, but without actual physical exertion. During the test, the patient’s heart function is examined using ultrasound and EKG. For more information, click here.

Doppler Ultrasound uses sound waves to visualize blood flow within the heart. This test may detect tumors, clots, blocked valves or leaking valves. It works by delivering high-frequency sound waves (ultrasound) through a wand-like device called a transducer. The waves pass through the body, bounce off the heart and echo back to create an image on the monitor. The images are then recorded and given to a physician for interpretation.  For more information, click here.

Echocardiogram uses sound waves to produce an image of the heart and evaluate its functioning. This test provides information about the size, shape and movement of the heart as well as valve function and blood flow. It works by delivering high-frequency sound waves (ultrasound) through a wand-like device called a transducer. The waves pass through the body, bounce off the heart and echo back to create a moving image on the monitor. The images are then recorded and given to a physician for interpretation. For more information, click here.

Mobile echocardiography and stress echocardiography units travel to a number of locations throughout the region. For information about the dates and times these services are offered, call Guthrie toll-free at 1-888-4GUTHRIE (1-888-448-8474). For more information, click here.

In Pennsylvania

Guthrie Clinic Wellsboro

Guthrie Clinic Dushore

Guthrie Clinic Tunkhannock

Guthrie Clinic Troy

Guthrie Clinic Wyalusing

Towanda Memorial Hospital in Towanda

Soldiers & Sailors Hospital in Wellsboro

Montrose General Hospital in Montrose

the office of Dr. Frank Moro in Carbondale, PA

 

In New York State

Guthrie Medical Group Big Flats

Guthrie Medical Group Vestal

Guthrie Medical Group Owego

Guthrie Medical Group Ithaca

Guthrie Medical Group Corning-Steuben

Schulyer Hospital in Watkins Glen, NY

Electrocardiogram (ECG or EKG) measures the electrical activity of the heart. This test can determine heart rhythm, size and heart chamber function. Small discs (electrodes) are placed on the skin in order to pick up electrical impulses from the heart. The electrodes are connected to an electrocardiogram machine which records the impulses. The recorded information is then given to a physician for interpretation. For more information, click here.

Electrophysiology Study (EPS) evaluates the heart’s electrical system in order to study irregular heart rhythms (arrhythmia). The test demonstrates how the heart reacts to controlled electrical signals to help identify the type of arrhythmia and how to control or prevent it. Small discs (electrodes) are placed on the skin in order to pick up electrical impulses from the heart. Long, thin wires are then inserted into the groin vein and gently guided under X-ray to the heart.  For more information, click here.

Multi-Unit Gated Blood Pool Scan (MUGA) shows how well the heart is pumping blood and can detect certain heart conditions. A low-level radioactive dye is injected through in intravenous line (I.V.) that attaches to the red blood cells so they can be seen. A nuclear camera then creates moving images of the beating heart. The images are recorded and then given to a physician for interpretation. For more information, click here.

Holter Monitoring records heart rate and rhythm over a period of 24 hours or more in order to evaluate an irregular heartbeat (arrhythmia). A battery-powered recording device is attached to either the shoulder or waist. Small discs (electrodes) are placed on the chest to pick up electrical impulses from the heart. The impulses are recorded onto a cassette tape that is given to a physician for interpretation. For more information, click here.

Nuclear Stress Test is used to evaluate heart disease by assessing blood flow to the heart. It is done in two stages, one while the patient is resting and one while the patient exercises. A radioactive compound is injected into a vein while the patient is at rest. A specialized gamma camera detects the presence of the compound in the heart. For the exercise portion of the test, small discs (electrodes) are placed on the skin to pick up electrical impulses from the heart. Then a second injection of radioactive compound in given during exercise, such as controlled walking on a treadmill. A second scan of the heart is done and the results are recorded and given to a physician for interpretation. For more information, click here.

Peripheral Vascular Angiography is a test used to evaluate blood flow to the extremities, such as the legs or neck. A catheter (thin tube) is inserted through a blood vessel in the leg or arm. Then a dye is injected and X-rays are taken of the arteries. The contrasting dye will show up on the X-ray and indicate narrowed or blocked arteries.

Stress Test (Stress Echocardiogram) helps determine the extent of heart disease by evaluating how the heart responds to controlled exercise. Small discs (electrodes) are placed on the skin to pick up electrical impulses from the heart. The patient walks on a treadmill and the pace is varied to see how the heart responds to the exertion. The results are recorded and given to a physician for interpretation. For more information, click here.

Tilt-Table Testing is used to diagnose a fainting condition known as syncope (sin-ko-pee). Individuals with syncope show a change in pulse and a drop in blood pressure when they stand up. For the test, the patient is strapped to a tilt table. The table is mechanically tilted to an upright position that simulates standing. Small discs (electrodes) are attached to the skin to pick up electrical impulses from the heart. Blood pressure and pulse are measured throughout the test. Patients are observed for symptoms and the information is given to a physician for interpreting.

Transesophageal Echocardiogram (TEE) uses sound waves to produce images of the heart and evaluate its functioning. This test provides detailed information on the size, shape and movement of the heart muscle. It is also able to check the condition of the heart valves, coronary arteries, and aorta (the main blood vessel supplying blood to your body). It works by using a tube-like device called a transducer that is placed in the mouth and guided down the esophagus. High frequency sound waves (ultrasound) are delivered through the transducer. The waves pass through the body, bounce off the heart and echo back to create a moving image on the monitor. The images are then recorded and given to the physician for interpreting. For more information, click here.

Treatment

The following procedures are often used in the treatment of cardiovascular disease. Consult your Guthrie physician or health care provider for more specific information.

Angioplasty (or Balloon Angioplasty) is used to open blocked arteries and improve blood flow to the heart. Using X-ray guidance, a thin wire is inserted into an artery in the leg to the blocked coronary artery. A small, balloon-tipped catheter (thin tube) is then guided over the wire to the blockage where the balloon is gently inflated to open up the artery so blood can flow through the area.  For more information, click here.

Beating-Heart CABG (Beating-Heart Coronary Artery Bypass Graft) is a surgical procedure used to treat patients with coronary artery blockages. Unlike traditional CABG, surgeons operate on a beating heart rather than placing patients on a heart-lung bypass machine to work on a still heart. Beating-heart CABG allows surgeons better access to certain parts of the heart and reduces recovery time and the likelihood of complications for patients.  For more information, click here.

Coronary Artery Bypass Graft (CABG) is a surgical procedure performed to improve blood flow to the heart when blood vessels are blocked. During the surgery, the patient is placed on a heart bypass machine (heart-lung machine) so the surgeon can operate on a non-beating heart. Veins or arteries from the patient's leg or chest are used to bypass the diseased arteries, creating a new route for oxygen-rich blood to flow to the heart. For more information, click here.

Coronary Artery Stenting is a procedure used to keep a blood vessel open and prevent it from collapsing. A stent is an expandable mesh tube that is placed in an artery for support. The procedure is performed under X-ray guidance using a small, balloon-tipped catheter (thin tube). The stent is placed on the end of the catheter, which is then inserted into an artery in the leg to the blockage. The balloon is gently inflated, which clears the clogged artery and opens the stent. For more information, click here.

Cutting Balloon Angioplasty is used to treat patients with blocked coronary arteries. Like traditional angioplasty, an X-ray guided catheter (thin tube) with a balloon on its tip is inserted into an artery in the leg. The catheter is threaded to the blockage and the balloon is inflated to open the artery. Cutting balloon angioplasty adds an additional step before the balloon is inflated. Tiny blades are used to score the plaque that has caused the blockage, which weakens the plaque and enables the balloon to be inflated at a lower pressure. This procedure is often used on patients with small arteries, or arteries that are branched or have already undergone angioplasty with stenting. The recovery time is the same as conventional angioplasty, but the recurrence of plaque buildup (restenosis) is reduced. For more information, click here.

Directional Coronary Artherectomy (DCA) is a method of clearing narrowing or blocked coronary arteries and restoring blood flow to the heart. A catheter (thin tube) is inserted through an artery in the leg to the heart under X-ray guidance. The tip of the catheter is equipped with a small cutting instrument that shaves off the plaque or cholesterol buildup that has formed in the arteries. The heart is then stimulated with small electrical signals. The impulses are recorded and then given to a physician for interpretation.

Heart Valve Surgery is a procedure to correct a damaged heart valve. Under general anesthesia, the surgeon will either repair or replace the valve depending upon the extent of the disease or damage.  For more information, click here.

Implantable Cardioverter Defibrillator (ICD) is a device that slows down an abnormally fast or erratic heart beat. The ICD is implanted in the chest where it monitors the patient’s heart beat. When an irregular heartbeat is detected, the unit sends a slight electrical shock to the heart, which returns the heartbeat to normal. For more information, click here.

Permanent Pacemaker is a device used to regulate an abnormal heartbeat. The pacemaker is surgically implanted into the chest of the patient. By sending timed electrical signals to the heart, the pacemaker helps provide a regular, reliable heart rhythm. A special type of pacing, called biventricular His-Bundle pacing, is used to locate a blockage in the electrical system of the heart and determine if pacemaker implantation is needed. Small discs (electrodes) are placed on the skin in order to pick up electrical impulses from the heart and a catheter (thin tube) is inserted through an artery in the leg to the heart under X-ray guidance. The catheter is equipped with an electrode that measures electrical activity of the His-bundle. The His-bundle is a group of electrical fibers in the heart that generate electrical impulses that help the heart heat normally.  For more information, click here.

Radiofrequency Ablation is a non-surgical procedure used to treat an abnormal heartbeat (arrhythmia). Using X-ray guidance, an electrode-tipped catheter (thin tube) is guided to the heart. Radiofrequency energy waves are delivered to the area of the heart where the arrhythmia exists. The heat created by the radiowaves causes a small area of scar tissue to develop, interrupting the irregular electrical activity and eliminating the abnormal heart rhythm. 

Rotablation is a technique for clearing clogged coronary arteries. It uses a special rotating blade to shave off the plaque built up on the artery wall that has caused the blockage. A catheter (thin tube) is inserted into an artery in the leg and guided to the blockage using X-ray technology. The tip of the catheter is equipped with a blade that pulverizes the plaque into very fine pieces. The procedure may be combined with balloon angioplasty or the placement of a stentFor more information, click here.

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Last Updated: December 4, 2007