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In-Hospital Services

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Percutaneous Coronary Intervention (Angioplasty)

Performed to open blocked coronary arteries and restore arterial blood flow to the heart tissue.

What is it?

Percutaneous coronary intervention (PCI, formerly known as Angioplasty with stent) allows doctors to open narrowed arteries caused by coronary artery disease without open heart surgery. A long, thin catheter (flexible tube) is inserted into the heart’s blood vessels. A stent is placed at the site of the narrowing, pushing the plaque buildup against the artery wall. This improves blood flow to the heart, which decrease heart-related chest pains. It will help you feel better and increase your activity tolerance.

What should I expect?

During an office visit, your cardiologist will discuss the risks and benefits of the procedure. This procedure will be then be scheduled because it must be done in a hospital. Shortly before the procedure, your cardiologist will again go over the risks and benefits.

Inform them if you:
  • Have ever had a reaction to contrast dye or iodine
  • Have asthma
  • Are allergic to any medications
  • Have any bleeding problems or are taking blood-thinners
  • Have a history of kidney problems or diabetes
  • Have body piercings on your chest or abdomen
  • Have had any recent change in your health
  • Are, or may be pregnant due to risk to the fetus

You will lay flat on an exam table and given a medication to help you relax. Most PCI procedures are performed with the patient sedated but not asleep. A local anesthetic will be given in the groin area where the catheter will be inserted. Once the catheter reaches the heart, a contrast dye will be released to show which vessels are narrowed. Some patients say they feel a warming sensation or brief headache from the dye. When the narrowed vessel is identified, a special tip on the end of the catheter will be advanced and activated.

When the procedure is over, the catheter is removed and pressure is applied to the groin area to stop any bleeding that may occur at the insertion site. A tight bandage will then be applied and you will be asked to remain flat for a period of time to reduce any risk of bleeding. You will be asked to increase your fluid intake as a way to help speed up the flushing of the dye from your system. An overnight stay in the hospital is typically required for observation. Keep an eye on the insertion site once at home. A small bruise is normal but inform your cardiologist if you experience any signs of infection such as increased pain, chills, redness, or swelling.

It is necessary to take medications such as aspirin, clopidogrel (Plavix), and prasugrel (Effient) to prevent blood clots from forming inside the stent. They work by decreasing the “stickiness” of blood cells that clump together to stop bleeding, known as platelets. Your cardiologist will provide specific instructions regarding which medications to take and for how long.


Diagnostic Heart Cathertization

A procedure used to diagnose and treat cardiovascular conditions.

What is it?

Cardiac catheterization is a common diagnostic test to evaluate the condition of the heart muscle, valves and blood vessels. A long, thin, flexible tube called a catheter is put into a blood vessel in the left or right side of the heart, usually through your arm or groin. Through the catheter, your cardiologist can do diagnostic tests and perform some treatments. Cardiac catheterization allows injection of a special dye necessary for angiography, as well as the ability to measure intracardiac pressures and oxygen saturations and also assists with the passage of instruments for electrophysiology, stenting and valvuloplasty balloons.

Why is it done?

Diagnostic cardiac catheterization allows the cardiologist to provide more accurate and detailed information about a diagnosis. It can be used to evaluate such conditions as:

  • Cardiac amyloidosis
  • Congenital heart defects
  • Outflow tract obstruction
  • Valve disease
  • Pulmonary hypertension
  • Coronary artery disease
  • Chest pain (agina)
  • Cardiomyopathy

What should I expect?

You are awake during the procedure, and it causes little or no pain. However, you may feel some soreness in the blood vessel where the catheter was inserted. You will be placed flat on an exam table in the hospital. A mild sedative is given to help you relax. The catheter will be inserted through a small incision made in the groin or upper arm. A special dye will be released to help with visualization of the blood vessels once the catheter is in place, and any necessary testing will take place. The catheter is removed when the testing is complete. You will be asked to remain flat for several hours, firm pressure will be applied to reduce bleeding at the insertion site. An overnight hospital stay will be required for observation. Keep an eye on the insertion site and let your cardiologist know if you see any signs of infections such as increased pain, redness, or swelling.

What are the risks involved?

Your cardiologist will the discuss the risks and benefits prior to the procedure. Cardiac catheterization is a generally safe procedure, but there are risks involved including:

  • Allergic reaction to the contrast dye
  • Cardiac tamponade
  • Bleeding, infection, and pain at the insertion site
  • Heart attack
  • Injury to coronary artery
  • Irregular heart beat
  • Stroke
  • Blood clots
  • Damage to the blood vessels
  • Kidney damage due to contrast dye

Be sure to discuss any questions or concerns with your cardiologist.


Carotid Artery Stenting

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Peripheral artery stenting

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Abdominal aortic aneurysm repair (Endovascular)

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Thombectomy to treat DVT

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Tilt table testing

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Cardiac ablation

Used to destroy small areas in the heart that may be causing heart rhythm problems.

What is it?

Cardiac ablation is a generally safe procedure used to treat certain abnormal heart rhythm problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risk of blood clots. It can also help control the heart rate that are beating too fast. Your cardiologist may discuss the need for a cardiac ablation to treat:

  • Atrial fibrillation and atrial flutter
  • Ventricular tachycardia
  • Complex arrhythmias (irregular heart rhythm)

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be awake the entire time but given a mild sedative to help you relax. A local anesthetic will be given to the puncture site, typically the groin. A small, flexible tube (catheter) will be inserted through into one of the blood vessels. The cardiologist uses live x-ray images to carefully guide the catheter up into your heart at the site of where the abnormal cardiac cells are. Once the source of the problem has been found, painless electrical energy is sent to destroy the heart muscles causing the irregular heart beat. This creates a small scar that causes the heart rhythm problem to stop.

After the procedure, you will be moved to a recovery room. Pressure will be applied to the catheter insertion site to prevent bleeding. You will be asked to remain flat in bed for several hours and your vital signs monitored. Tell your doctor or nurse if you have any chest pain, bleeding, or signs of infection such as redness, swelling, and increased pain.

Your cardiologist will discuss with you any medications that will need to taken after the procedure and when you can return to normal activity.


Diagnostic EP studies

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Implanted loop recorders

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Pacemaker implant

What is it?

A pacemaker is a small device implanted in the chest or abdomen to help control abnormal heart rhythms if it is beating too fast (tachycardia) or too slow (bradycardia). It uses electrical pulses to prompt the heart to beat at a normal rate.

If the heart is beating too fast or too slow, the heart may not be able to pump enough blood to the body. This can cause symptoms such as fatigue, shortness of breath, or evening fainting. Severe irregular heart rhythms can damage the body’s vital organs because of the lack of oxygen and may even cause loss of consciousness or death.

A pacemaker can relieve some arrhythmia symptoms, such as fatigue and fainting. A pacemaker also can help a person who has abnormal heart rhythms resume a more active lifestyle.

What should I expect?

The procedure to implant a pacemaker is usually quick. It does not require open-heart surgery, and most people go home within 24 hours. Before the surgery, medication is usually given to make you sleepy and comfortable. The procedure is performed under local anesthesia.


Defibrillator implant

Your heart is a muscle that works like a pump. It has four chambers, two upper chambers called atria and two lower chambers called ventricles. Your heart’s pumping energy comes from a built-in electrical conduction system that must pump together in harmony to produced a normal heartbeat. Any malfunction in these signals can make your heart beat too quickly, too slowly, or at an uneven rate. This causes an arrhythmia, or abnormal heart rhythm.

What is an defibrillator?

An implantable cardioverter-defibrillator (ICD) is a small battery-powered implanted device under the skin of the upper chest capable of correcting life-threatening cardiac arrhythmias such as ventricular fibrillation. It works by detecting abnormal heart rhythms and delivering low-energy to high-energy shocks to return the heart to a regular heart rhythm. Current device batteries last about 6–10 years, after which the ICD needs to be replaced.

Do I need an ICD?

At Heart Center of Nevada we have specially trained cardiologists in electrophysiology that will consult with you if an implanted device may be needed. They will discuss with you the need for an ICD if you are at risk of having a life-threatening cardiac arrhythmia related to:

  • A ventricular arrhythmia
  • Brugada syndrome
  • Long QT syndrome
  • Heart attack
  • A survived sudden cardiac arrest
  • A congenital heart disease or other underlying conditions for sudden cardiac arrest

What is the follow-up care?

You will need to schedule regular ICD checkups as determined by your cardiologist after the implantation. These can be completed in our office at your convenience. The chip inside the device will be connected a special computer by one of our technicians to ensure it is functioning properly. During the visit, the technician and cardiologist will:

  • Check the battery status
  • Review any heart rhythm events that may have occurred since your last appointment
  • Check that your device is set to levels appropriate for your needs and make any necessary adjustments
  • Assess any symptoms, questions, or concerns you may be having.

Laser lead extraction

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Subcutaneous ICD implant

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.


Transesophogeal echocardiogram (TEE)

What is it?

A transesophageal echocardiogram (TEE) is a special type of echocardiogram that uses sound waves to examine the heart’s structures. Your cardiologist may recommend it as a way to more closely see the heart’s shape, size, condition of the aorta, and if you are at risk for blood clots. The major difference between between a standard echocardiogram and a TEE is that a small wand is passed down your throat through to your esophagus versus it moving on the outside of your chest.

What should I expect?

You will connected to a machine that will watch your heart rate and rhythm. You may be given a sedative to help you relax prior to the procedure. Your throat will be sprayed with an anesthetic before a small, flexible probe is inserted into your mouth and moved down into your esophagus. You may be able to feel the probe move during the procedure but it will not interfere with your breathing or cause any pain. The sound waves that bounce off your heart are converted into pictures on a monitor that your cardiologist will be continuously monitoring. The test usually takes about 20 to 40 minutes and is done in a hospital.

How do I prepare?

You will be asked not eat or drink anything for 4 to 6 hours before the procedure. Talk to your cardiologist about any prescribed medications in the case the medications need to be stopped.

Are there side effects?

You may feel a little sleepy after the sedative has worn off so please arrange to have someone drive you home. You may find that you have a sore throat after the procedure. These side effects usually go away after a couple days.


Transcatheter aortic valve replacement (TAVR)

For high-risk patients and those who are not suitable for open-heart surgery, another option is now available to treat aortic stenosis.

Transcatheter Aortic Valve Replacement (TAVR) is an innovative procedure performed at Heart Center of Nevada by Nayab Zafar, M.D., FACC. Dr. Zafar’s expanded training and expertise in this field has made it possible for patients who could not, or do not wish to, undergo open heart surgery receive much needed treatment.

What is TAVR?

TAVR is a new approach to the treatment of severe aortic stenosis, a condition in which the aortic valve becomes narrowed, blocking the outflow of blood from the heart and thereby requiring the heart to work harder to pump blood to the whole body. As the disease progresses, some symptoms the patient may experience include fatigue and shortness of breath. This procedure can also be used on patients who are considered high risk for surgery due to advanced age or other serious illness.

What should I expect?

Instead of a very invasive procedure like the standard open heart surgery, a balloon catheter is placed through the groin with a local anesthesia and guided into the heart. A compressed heart valve is then placed in the catheter and positioned directly inside the diseased aortic valve. Once in position, the balloon is inflated to secure the new valve in place.

What are the risks?

TAVR implantation has some rare but serious risks that you should know about and discuss with your cardiologist before deciding on this procedure. It is not right for all patients. In certain cases, the risks of the may outweigh the benefits.


Valvuloplasty

What is it?

This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body. This service is a generally safe procedure used to treat certain health problems that medicines are not controlling or for side effects. These problems may be dangerous for you if they are not treated due to the risks. It can also help control the health and function of your body.

What should I expect?

This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax. This procedure will be schedule ahead of time, as it needs to be performed in a hospital. You will be in the confortable state of being for the procedure the entire time but given the necessary medications to help you relax.