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Office Services
SERVICES
Electrocardiogram (EKG OR ECG)
Treadmill Testing
Stress Myocardial Perfusion Scan
Pharmacologic Stress Testing
Resting & Stress Echocardiograms
Holter Monitor
Event Monitor
Signal Averaged EKG/T-Wave Alternans Test
Cardiopulmonary Stress Test
Impedance Cardiography
Ankle Brachial Index Testing
Peripheral Vascular Interventions
ICD Patient Support Group
Protime Clinic
Enhanced External Counterpulsation
TREATMENTS
Implantable Cardiac Defibrillator (ICD) Clinic
Carotid Ultrasound
Peripheral Vascular Evaluation
REHABILITATION AND SUPPORT
Pacemaker Clinic
Cardiac Rehabilitation
CLINICAL RESEARCH
ADCA Research
CATH LAB SERVICES
We offer state of the art comprehensive inpatient diagnostic and therapeutic services at catheterization labs at several local hospitals:
Cardiac Catheterization and Angiography
Ballon Coronary Angioplasty
Coronary Artery Stent Placement, including drug eluding stents
Coronary Rotablator/Cutting Ballon
Electrophysiology Studies
ASD/P FO Closures
Radiofrequency Ablation
Electrical Cardioversion
AICD Implantation, including Bi-ventricular ICDs
Pacemaker Implantation, including Bi-ventricular pacemakers
Tilt Table Testing
Transesophageal Echocardiography
ELECTROCARDIOGRAM (EKG OR ECG)
Aurora, Denver, Lone Tree, Parker, and Frisco
An electrocardiogram – abbreviated as EKG or ECG – is a test that measures the electrical activity of the heartbeat. With each beat, an electrical impulse (or “wave”) travels through the heart. This wave causes the muscle to squeeze and pump blood from the heart.
An ECG gives two major kinds of information. First, by measuring time intervals on the ECG, a doctor can determine how long the electrical wave takes to pass through the heart. Finding out how long a wave takes to travel from one part of the heart to the next shows if the electrical activity is normal or slow, fast or irregular. Second, by measuring the amount of electrical activity passing through the heart muscle, a pediatric cardiologist may be able to find out if parts of the heart are too large or are overworked.
There’s no pain or risk associated with having an electrocardiogram. When the ECG stickers are removed, there may be some minor discomfort. The machine only records the ECG. It doesn’t send electricity into the body.
Prepared by AHA’s Committee on Congenital Cardiac Defects of the Council on Cardiovascular Disease in the Young.
TREADMILL TESTING
Aurora, Denver, Lone Tree, Parker, & Frisco
This is an option that provokes arrhythmias and makes their diagnosis (and thus their proper treatment) easier. A treadmill test may be used for people whose suspected arrhythmias are clearly exercise-related. It is important to know if exercise makes an arrhythmia worse. To test this, you will walk and run on a treadmill — or ride a stationary bicycle — while your heart rate and rhythm are monitored.
STRESS MYOCARDIAL PERFUSION SCAN
Aurora, Denver, Lone Tree & Parker
Single Photon Emission Computed Tomography (SPECT) of the heart is a well-established nuclear imaging technique. It involves taking a series of pictures around the chest after injecting a radioactive tracer into the blood. Then computer graphics are used to create images of slices through the heart. This technique has been applied to the heart for myocardial perfusion (mi"o-KAR'de-al per-FU'zhun) (blood flow) imaging with agents like thallium-201 and the technetium-based myocardial perfusion tracers. These agents are injected either at rest or with exercise or pharmacologic stress.
PHARMACOLOGIC STRESS TESTING
Aurora, Denver, Lone Tree, & Parker
Twenty to thirty percent of heart patients cannot exercise adequately (for a variety of reasons), or need special imaging studies to answer specific questions, such as positron emission tomography or dobutamine echocardiography to determine if areas of the myocardium are hibernating. In these patients, pharmacologic "stress" with adenosine, dipyridamole, or dobutamine can be used before obtaining nuclear perfusion images, gated or first-pass radionuclide ventriculographic images, or a series of echocardiographic images.
The effect of dipyridamole on adenosine reuptake is blocked by aminophylline and caffeine, and for this reason these substances need to be stopped 24 hours before the test. Most patients know to avoid coffee and likely tea, but it is important to remind them about chocolate, colas, and decaffeinated products, as these still contain a significant amount of caffeine.
Every patient has a test that is best for him or her and the question being asked. It is possible, usually safe, and very important to optimize results through adjustment in medications. If there is any uncertainty about the stability of the coronary symptoms, however, coronary arteriography is safe and reliable alternative.
RESTING & STRESS ECHOCARDIOGRAMS
Aurora, Denver, Lone Tree,& Parker
Stress echocardiography or "stress echo" is an echocardiogram done before and during or immediately after some form of physical stress (such as bicycle or treadmill exercise). It's used to help diagnose coronary heart disease.
HOLTER MONITORS
Aurora, Denver, Lone Tree, & Parker
The Holter monitor is a device that records the heart rhythm continuously for 24 hours. This means that it records each and every heart beat over that time. Sticky patches (electrodes) on the chest are connected to wires from the Holter monitor. The monitor is carried with the patient for the recording period. The heart rhythm is recorded onto a cassette tape or flash card technology and then processed at a heart center. From this recording, a wide variety of information can be obtained including heart rates during day and night, abnormal heart beats, and recording of rhythm during any symptoms during the recording. A diary comes with the Holter for the patient or caregiver to write down the time and type of symptoms so the rhythm can be reviewed.
SIGNAL AVERAGED EKG/T-WAVE ALTERNANS TESTS
Aurora, Denver, Lone Tree& Parker
EVENT MONITORS
Aurora, Denver, Lone Tree & Parker
Event monitors are small devices that are used by patients over a longer period (weeks to months, typically one month). Two sticky patches (electrodes) on the chest connect two wires to the event recorder. The monitor is always on but will only store the patient’s rhythm when the patient or caregiver pushes the button. Most monitors will save the rhythm for several seconds of rhythm before the button is even pushed. The rhythm is also saved for a period after the button is pushed. A few specialized monitors are used only after the patient has symptoms. The intent is for most event monitors to be worn as much as possible every day to increase the chances of recording the patient’s rhythm when he/she has symptoms.
CARDIOPULMONARY STRESS TEST
Aurora & Denver
A cardiopulmonary stress test (CPX test) is a special treadmill test. This test takes an ECG and measures how your lungs work while you exercise. Your doctor may ask you to take a CPX test to see if you have any cardiac or respiratory problems during exercise and to determine how well the heart pumps blood to the muscles. This information is needed to determine the best exercise plan for you.
For the test, ECG wires will be attached to your chest for an electrocardiogram of your heart. You will breathe into a breath analyzer that measures the gas exchange in your lungs. An oximeter will be placed on your finger to determine how much oxygen is in your blood while you exercise. Your blood pressure and pulse will be taken during the test.
You will start out by walking slowly on the treadmill. You will be asked to gradually increase your speed and incline. You can stop the test at any time. If at any point during the test you feel as if you have had enough, give the “thumbs down” signal to the exercise physiologist and doctor. They will slow down the treadmill and stop the test. The results of the test will help your doctor choose a target heart rate for you to reach when you exercise and decide the best exercise for you.
IMPEDANCE CARDIOGRAPHY
Aurora
Impedance cardiography is a completely noninvasive test that can be performed at Aurora Denver Cardiology’s Medical Center of Aurora office to provide information about your heart's ability to deliver blood to the rest of your body, the force your heart has to pump against with each heartbeat, and the amount of fluid in your chest.
The impedance cardiography test does not replace any tests that your physician is currently performing. Many patients are familiar with the ECG (or EKG) test, which measures the electrical function of the heart. Impedance cardiography measures the mechanical function of the heart, and provides different information than an ECG.
Source of information about impedance is from the CardioDynamics website.
ENHANCED EXTERNAL COUNTERPULSATION (EECP)
Denver
At the PSL Medical Center office of Aurora Denver Cardiology EECP is offered as a noninvasive, atraumatic procedure that can reduce the symptoms of angina pectoris, presumably by increasing coronary blood flow in ischemic areas of the heart.
The beneficial effects of EECP on perfusion of the ischemic myocardium in patients with coronary artery disease appear to be sustained between treatments, and may persist long after completion of a course of therapy.
Enhanced External Counterpulsation involves the use of the EECP Device to inflate and deflate a series of compressive cuffs wrapped around the patient's calves, lower thighs, and upper thighs. Inflation and deflation of the cuffs are modulated by events in the cardiac cycle via computer-interpreted ECG signals.
IMPLANTABLE CARDIAC DEFIBRILLATOR (ICD) CLINIC
Aurora, Denver, & Parker
An implantable cardioverter defibrillator is used in patients at risk for recurrent, sustained ventricular tachycardia or fibrillation.
The device is connected to leads positioned inside the heart or on its surface. These leads are used to deliver electrical shocks, sense the cardiac rhythm and sometimes pace the heart, as needed. The various leads are tunnelled to a pulse generator, which is implanted in a pouch beneath the skin of the chest or abdomen. These generators are typically a little larger than a wallet and have electronics that automatically monitor and treat heart rhythms recognized as abnormal. Newer devices are smaller and have simpler lead systems. They can be installed through blood vessels, eliminating the need for open chest surgery.
When an implantable cardioverter defibrillator detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm. New devices also provide overdrive pacing to electrically convert a sustained ventricular tachycardia, and "backup" pacing if bradycardia occurs. They also offer a host of other sophisticated functions (such as storage of detected arrhythmic events and the ability to do "noninvasive" electrophysiologic testing).
ICD PATIENT SUPPORT GROUP
Aurora, Denver, & Lone Tree
Aurora Denver Cardiology Associates knows the importance of continual education and support for heart patients to maintain health restablish quality of life. ICD support groups are offered at these offices.
PACEMAKER CLINIC
Aurora, Denver, Lone Tree& Parker
Aurora Denver Cardiology’s Pacemaker Clinics are designed to follow patients once a permanent device, such as a pacemaker or AICD, Automatic Implantable Cardiac Defibrillator, has been implanted. Our clinical team includes highly trained and experienced cardiologists, registered nurses, technologists, and manufacturing representatives when needed.
ANKLE BRACHIAL INDEX TESTING
Aurora, Denver, Lone Tree & Parker
The Ankle Brachial Index Test is done by measuring blood pressure at the ankle and in the arm while a person is at rest. Measurements are then repeated at both sites after 5 minutes of walking on a treadmill.
By dividing the highest blood pressure at the ankle by the highest recorded pressure in either arm, the ankle-brachial index (ABI) can be calculated. The ABI result is used to predict the severity of peripheral arterial disease that may be present. A decrease in the ABI result with exercise is a sensitive indicator that significant PAD is probably present.
CARDIAC REHABILITATION
Aurora & Denver
As a general rule, it's better for people with heart failure stay active. That might sound like contradictory advice, since the heart is already having trouble keeping up with the body's demands. Why make it work even harder?
Moderate physical activity can help the heart get stronger. Most people find that exercise improves their symptoms, reduces stress and boosts energy levels. Regular physical activity also may lead to other important health advantages, including weight control, weight loss, better circulation and blood pressure, and lower cholesterol levels — all of which are especially important if you have heart failure.
The healthcare team will work with you to develop an appropriate exercise plan. Often they'll start by giving you a stress test to measure your heart function during exercise (either walking on a treadmill or riding an exercise bike). This helps the physician know how much activity your heart can handle.
Source: AHA
PROTIME CLINIC
Aurora, Denver, Lone Tree & Parker
The clinic staff and cardiologists have developed a Protime Clinic in order to assist patients with regulating their Coumadin® levels. The process involves a finger stick, regulation of Coumadin® and scheduling of next protime check.
Coumadin® (generic is Warfarin) is a medication that slows the blood clotting process. It is used in persons who have either recently formed a blood clot or are at risk for forming them.
The test must be done once a month after your Coumadin® dose has stabilized. However, if a change is made in your dosage, your blood will be tested weekly until stable. These are general guidelines that are applied to all of our patients. The frequency of testing will also depend on your clinical condition and physician's recommendations. Those patients who benefit the most from the Protime Clinic are those who adhere to their medication instructions and scheduled appointments.
CLINICAL RESEARCH
Aurora Denver Cardiololgy Associates remains committed to being on the leading edge in research and the application of the latest technology in patient care. Click here to view the latest information on our research program at our offices.
CAROTID ULTRASOUND
Aurora Denver Cardiololgy Associates provides ultrasound imaging of the carotid artery in the neck to find plaque buildups that may help predict heart attacks and other coronary events in otherwise low-risk adults.