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	PACEMAKER & DEFIBRILLATOR CLINIC
	The pacemaker/defibrillator clinic duties include checking pacemakers and defibrillators for regular evaluations and reprogramming.
	Scheduling follow-up appointments, and telephonic checks. Pacemaker/defibrillator battery change out implants are done here in the clinic as well.
	Other tasks include:
	Holter Scanning
	Wound site evaluations for new implant
	Keeping an updated patient file system in the pacemaker art computer and pacemaker/defibrillator patients charts in file cabinets.
	DIAGNOSTIC TESTS
	Tilt Table
	What is a Tilt Table Test?
	If you have had recurrent syncope (fainting spells), the tilt table test can help determine how your body responds to changes in position. During the test, you lie on a table that can be moved to a nearly upright position while your symptoms, heart rate, and blood pressure are continuously monitored.
	What Does the Tilt Table Test Show?
	The tilt table test is designed to induce (bring on) syncope under controlled conditions. It is especially useful for diagnosing vasovagal syncope.
	What Happens During the Test?
	During the test, you will be instructed to lay down on a special table, called a tilt table. The intravenous line is inserted in one arm, and a blood pressure cuff (or a similar device) is placed on the other arm. The ECG electrodes on your chest allow the doctor to monitor your heart rhythm. Safety straps are applied across your chest and legs. You will be continuously monitored in the tilted position for up to 45 minutes and then returned to a flat position.
	What Are the Benefits?
	The tilt table test helps doctors determine whether or not you are susceptible to vasovagal syncope. The information gained from this test helps your doctor make an accurate diagnosis and develop a treatment plan that's best for you.
	Echocardiogram
	An echocardiogram is a test that uses ultrasound waves to examine the heart. It is a safe and painless procedure that helps doctors diagnose a variety of heart problems. During the test, a transducer (a small microphone-like device) is held against the chest. The transducer sends ultrasound waves that reflect echo off the various parts of the heart. The echocardiogram provides doctors with important information about the heart. This test can be performed in the doctor's office or at the hospital. No special preparation is necessary for this test. A thorough examination usually takes from 20 minutes to an hour, depending on the number of views and whether the Doppler echo is used. The echocardiogram is very safe. There are no known risks from the ultrasound waves. It is also painless, although you may feel slight discomfort when the transducer is held firmly against the chest. The major benefit of this test is that it gives information about the heart's structures and blood flow without anything entering the body. This information helps your doctor make an accurate diagnosis and develop a treatment plan that's best for you.
	TEE (Transesophageal echocardiography)
	Transesophageal echocardiography is a test that allows your doctor to record images of your heart from inside your esophagus, or food pipe. Since the esophagus lies just behind the heart, TEE may produce clearer pictures of the heart's movement than would standard echocardiography taken from outside the chest. During TEE, harmless sound waves bounce (echo) off your heart. These sound waves create images of your heart as it pumps blood throughout the valves of your heart as it pumps blood throughout the valves and chambers.
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	CAD (coronary artery disease)
	The heart receives life-giving blood from vessels called coronary arteries. If these arteries become partially blocked or narrowed by the accumulation of fatty materials, the heart may not receive the blood it needs to function properly. This narrowing of coronary arteries is called coronary atherosclerosis or, more commonly, coronary artery disease (CAD). As CAD progresses, the heart muscle may not receive enough blood when under stress, for example, when exercising. This often results in chest pain called angina pectoris. On the other hand, there may be no outward physical signs of the disease. If CAD is limiting blood flow to a part of your heart, the stress exam with CARDIOLITE may be useful in detection the presence and significance of CAD. This exam usually consists of two parts, rest and stress:
	--CARDIOLITE will be administered by injection while you are at rest, and a special camera will take pictures of your heart.
	--CARDIOLITE will be administered to you one other time by an injection during exercise (the "stress" portion of the test), and additional pictures will be taken of your heart.
	This allows the physician to compare the amount of blood flowing through the heart muscle during stress and at rest. The pictures are generally taken about one-half hour or later, after CARDIOLITE is administered.
	Stress EKG
	The stress EKG, or stress test, conducted while you exercise on a treadmill or stationary bicycle, measures your heart's health under the stress of physical activity. Your blood pressure and pulse are also monitored by a specially trained technician, an expert in using stress test equipment. Results will be evaluated by a cardiologist or your physician. The stress EKG aids in determining how fit you are and how safe an exercise program is for you, or if a heart problem exists. During the test a technician will place electrodes, or metal discs, on your arms, shoulders, and chest. These electrodes are connected by wires to the electrocardiograph machine. An EKG at rest will be taken first. You will then step onto the treadmill or stationary bicycle and exercise according to your doctor's instructions. Your blood pressure and pulse are checked during and after the test.
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