Tilt Table Testing: This test is used for evaluating the cause of fainting. A tilt table test helps doctors pinpoint the cause of fainting. It checks how changes in the body position can affect blood pressure. The patient is placed on a table that is slowly tilted upward. The test tries to recreate fainting symptoms while your blood pressure and heart rate are monitored.

If you are having a tilt table test, make sure you ask the nurse if there are any medications you should not be taking. Do not eat or drink anything after midnight before the test (if you are allowed to take medications, please only take them with a sip of water). Wear a two-piece comfortable outfit since you will undress from the waist up and wear a hospital gown. This test will usually take about one hour. Please arrive early to check in.

During the test you are hooked up to a heart monitor and an IV may be placed to deliver fluids. You will lie on a table and straps are put on to hold you in place. You are slowly tilted up to about 80 degrees. During this time, your pulse and blood pressure will be monitored closely.

 Pacemaker: A pacemaker is a small electronic device that is placed inside your body. It monitors your heartbeat and, when necessary, generates electrical signals similar to the hearts natural signals. This keeps the heart from beating too slowly. There are two types of pacemakers: single-chamber (one lead) and dual chamber pacemakers (two leads).

 Pacemaker Implantation Procedure: Ask your doctor if there is any medication that you need to stop taking before your procedure. Do not eat or drink anything 6 hours prior to the procedure. The most common insertion method is endocardial implantation. This procedure takes approximately two hours. You are put under conscious sedation. This means you are awake during the procedure but you will not remember it. A local anesthetic is given to numb the area where the pacemaker is going to be inserted. An incision is made below the collar bone and a pocket is made between the layer of muscle and fat tissue for the pacemaker to sit. The leads are threaded in to an opening made in the vein and the leads are guided into your heart using x-ray technology. After the leads are in place, they are connected to the generator which is inserted under your skin. The device is then tested and the incision site is closed. There is one alternative procedure where the lead is placed outside of the heart and the generator is placed under the skin in the abdomen. The life of the pacemaker battery lasts for 5 to 10 years before they need to be replaced. This means that the whole generator needs to be replaced because the battery is sealed inside it.

 ICD (Implantable Cardioverter Defibrillator): An ICD is a small electronic device that is implanted into your body. It monitors your heart rhythm and when you have arrhythmia it helps you heart return to its normal sinus rhythm. It has multiple functions. It works to correct a fast rhythm which is called ATP (antitachycardia pacing). If the ATP is unable to slow a fast rhythm, the ICD will give the heart a shock. Also, if there it senses a very fast irregular rhythm, it sends a strong shock to the heart to override the fast rhythm. These shocks can feel like a horse kicked you in the chest. All ICD's have pacemaker capabilities.

 ICD Implantation Procedure: Ask your doctor if there is any medication that you need to stop taking before your procedure. Do not eat or drink anything for 6 hours prior to the procedure. The most common insertion method is endocardial implantation. This procedure takes approximately two hours. You are put under conscious sedation, which means you are awake during this procedure but you will not remember it. A local anesthesia is given to numb the area where the ICD is going to be inserted. An incision is made below the collarbone and a pocket is made between the layer of muscle and fat tissue for the ICD to sit. The leads are threaded into an opening made in the vein and the leads are guided into your heart using x-ray technology. After the leads are in place, they are connected to a generator which is inserted under your skin. The device is then tested and the incision site is then closed. There is one alternative procedure where the lead is placed outside the heart and the generator is placed under the skin of the abdomen. The life of the ICD battery lasts for 5 to 8 years before it needs to be replaced. This means that the whole generator needs to be replaced because the battery is sealed inside it.

 Biventricular Pacemaker: The purpose of this pacemaker is to make sure that the left and right heart chambers are contracting in synch. A lead in the right atrium senses an electrical signal and this signal sends electrical impulses to the right and left ventricles. These impulses synchronize the chambers contraction.

 Biventricular Pacemaker Implantation Procedure: Ask your doctor if there is any medication that you need to stop before your procedure. Do not eat or drink anything for 6 hours prior to the procedure. The most common insertion method is endocardial implantation. This procedure takes approximately two hours. You are put under conscious sedation, which means you are awake during this procedure but you will not remember it. A local anesthesia is given to numb the area where the ICD is going to be inserted. An incision is made below the collarbone and a pocket is made between the layer of muscle and fat tissue for the ICD to sit. The leads are threaded into an opening made in the vein and then guided into your heart using x-ray technology. After the leads are in place, they are connected to a generator and that is inserted under your skin. The device is then tested and the incision site is then closed. There is one alternative procedure where the lead is placed outside the heart and the generator is placed under the skin of the abdomen. The life of the ICD battery lasts for 5 to 8 years before it needs to be replaced. This means that the whole generator needs to be replaced because the battery is sealed inside it.

 Biventricular ICD (Implantable Cardioverter Defibrillator): The purpose of this ICD is to make sure the left and right heart chambers are contracting in synch. A lead in the right atrium senses and electrical signal and this signal sends electrical impulses to the right and left ventricles. These impulses synchronize the chambers contraction. This device keeps the heart in rhythm like the biventricular pacemaker, but it also has an internal cardioverter/defibrillator to correct the heart should it go into a fast, life threatening rhythm.

Biventricular ICD Implantation Procedure: Ask your doctor if there is any medication that you need to stop before your procedure. Do not eat or drink anything for 6 hours prior to the procedure. The most common insertion method is endocardial implantation. This procedure takes approximately two hours. You are put under conscious sedation, which means you are awake during this procedure but you will not remember it. A local anesthesia is given to numb the area where the ICD is going to be inserted. An incision is made below the collarbone and a pocket is made between the layer of muscle and fat tissue for the ICD to sit. The leads are threaded into an opening made in the vein and then guided into your heart using x-ray technology. After the leads are in place, they are connected to a generator and that is inserted under your skin. The device is then tested and the incision site is closed. There is one alternative procedure where the lead is placed outside the heart and the generator is placed under the skin of the abdomen. The life of the ICD battery lasts for 5 to 8 years before it needs to be replaced. This means that the whole generator needs to be replaced because the battery is sealed inside it.

Atrial Fibrillation Cardiac Catheter Ablation Procedures

 Atrial Fibrillation Ablation Procedures: Atrial fibrillation ablation procedures now represent a new treatment option for patients with troublesome atrial fibrillation which has not responded to medical therapy. While not a perfect procedure, it does offer up to an 80% chance of being free from atrial fibrillation. One study has suggested that ablation of the atrial fibrillation may offer a decreased risk of long-term complications from atrial fibrillation (stroke, heart failure, or death), however the design of this study was not perfect and it has not yet been validated by other studies.

There is a 20-30% chance you may require a second procedure or may still require ongoing medical therapy to suppress your atrial fibrillation following the ablation. In addition, atrial fibrillation ablation procedures are a higher risk ablation procedure and carry a risk of a stroke, tear in the heart or esophagus, death or other unforeseen procedural complications. Thus, the procedure is recommended only for patients who have significant symptoms from atrial fibrillation and medical therapy has either been ineffective of not tolerated. Careful attention to the following instructions may help to minimize complications. If you have any questions or do not understand these instructions, please call Utah Heart Clinic at (801) 408-3900 or toll free at 888-598-1300.

 Cardioversion: Cardioversion is the use of timed shock to convert certain types of abnormal heart rhythms.

 Cardioversion Procedure: Patient should not have anything to eat or drink for 12 hours prior to procedure. Patients need to have someone to drive them home from the procedure. The patient is given a strong sedative so that they will not feel the shock. The patient is hooked up to a heart monitor, defibrillator pads are placed on the chest, and the electrical charges are timed and controlled.