Heart Clinics Northwest, The Heart Institute, Spokane, Washington, Your Heart

General Information:

We are pleased to offer the following tests for invasive evaluation and therapy for specific illnesses. All of the invasive tests must be performed in an approved, outpatient or inpatient cardiac catheterization suite. They can be scheduled after consultation with one of our physicians to perform the appropriate diagnostic or therapeutic procedure. Performance of the procedure can be accomplished at Northwest Cardiac and Vascular Imaging located in The Heart Institute of Spokane, Sacred Heart Medical Center, Deaconess Medical Center, Valley Hospital and Medical Center, Holy Family Hospital, Kootenai Medical Center in Coeur d’Alene, ID, Bonner General Hospital in Sandpoint, ID, and St. Mary Medical Center in Walla Walla, WA. Not all procedures are available at all locations, nor are all procedures covered by insurance at all locations. Insurance approval and scheduling can be done through the office at the time of consultation.

	Purpose	Preparation
Cardiac Catheterization	Cardiac Catheterization is an invasive examination where after appropriate sedation and local anesthesia, catheters are threaded from an arm, neck, or leg artery and/or vein into the heart and great vessels to measure pressures and/or oxygen content within that cardiac chamber or vessel.	This examination usually requires approximately 30 minutes. It requires arrival at the appropriate facility approximately 90 minutes before the scheduled exam with the patient fasting for 4-6 hours prior to the test. Aspirin and other platelet inhibitors are not normally restricted prior to the exam, but other forms of anticoagulation may be restricted and the patient must check with the physician prior to the test for specific instructions. Appropriate gowns and clothing will be provided during the test. Iodine or shellfish sensitivity should be brought to the attention of the healthcare providers before the test is performed
Angiography –coronary, aortic, peripheral, e.g., carotid, renal, iliofemoral	This invasive examination occurs with the injection of iodine-based contrast dye into the artery to further outline and detect vascular abnormalities in that vessel.	Angiography is performed as part of cardiac catheterization when appropriate. No other special preparation beyond that described for cardiac catheterization is needed.
Initial Electro-physiologic Cardiac Conduction System Mapping	This invasive examination involves placement of catheters within the heart to assess the electrical system function of the heart. Attempts to provoke an abnormal cardiac rhythm with pacing, intravenous medication, etc. may be attempted concomitantly.	This examination normally requires approximately 60-120 minutes. It must be done in an approved facility with specialized technician training and equipment. Patient preparation is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above)
Transesophageal Echocardiography	This examination involves placement of a scope through the pharynx after appropriate sedation and anesthesia to then image the heart and great vessels with the use of ultrasound. It is done to assess valve function, cardiac muscle function, possible cardiac tumors or masses, etc.	This test can be performed on an in or outpatient basis. It requires arrival approximately 60 minutes prior to the test in an outpatient facility. The patient must be fasting for at least 8 hours prior to the test. No other special preparation or clothing is required. No medications need be held prior to the examination.

	Purpose	Preparation
Percutaneous Intervention – coronary, peripheral artery	These therapeutic procedures, in general, involve reestablishment of improved blood flow to the downstream organ by placement of a stent, balloon inflation, or atherectomy procedure. They are performed after angiography has documented that percutaneous intervention is appropriate and technically possible.	Preparation for these tests is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above). These procedures must be done in an approved specialized facility.
Therapeutic Electrophysiology – permanent pace-maker insertion, defibrillator placement	Pacemakers or defibrillators are implanted to provide improved control on individual patients with rhythm disorders. Pacemaker implantation can be used to improve slow or absent cardiac rhythms or improve cardiac muscle performance. Defibrillators are used to convert rapid, possibly lethal cardiac rhythms back to normal rhythm by the process of shocking the heart back to an electrically normal rhythm.	These procedures must be done in an approved facility, usually on an inpatient basis. Preparation is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above).