Hospital-Based Services

Dr. Alrich L. Gray // Central Montana Heart & Vascular Institute

Angioplasty & Stents

Angioplasty is a minimally invasive intervention method that uses a balloon-tipped catheter to dilate your artery. Once inserted, the balloon is inflated at the blockage site to compress the plaque against the wall of the artery, increasing the flow of blood. In order to prevent the artery from becoming blocked again long-term, a small tube called a stent is sometimes put in place.

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Atherectomy is a non-surgical intervention that removes plaque using a catheter with either a sharp blade or small drill on its tip. The plaque is either captured by the end of the catheter or is broken up and safely released into the bloodstream.

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Cardiac Catheterization

A cardiac catheterization (cardiac cath or heart cath) is a procedure used to diagnose and treat certain conditions. A thin, hollow tube called a catheter is inserted in an artery or vein in your groin, neck, or wrist and threaded through your blood vessels to your heart. A cardiac cath is performed to find out if you have disease of the heart muscle, valves, or coronary arteries. Your pressure and blood flow can also be measured during a cardiac catheterization.

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DC Electric Cardioversion

A DC electrical cardioversion (direct current cardioversion) is a procedure used to convert an abnormal heart rhythm to a normal heart rhythm. Your doctor may perform a DC electrical cardioversion if your heart is beating extremely fast or if it is in an abnormal heart rhythm in order to restore normal rhythm. During the procedure, you are sedated, and an electrical shock is sent through your heart via pads or paddles. This electrical shock will typically reset your heart rhythm to normal.

Cardioversions have quick recovery times, and you will most likely go home the same day as your procedure.

Cardiac Diagnostic Studies

Cardiac Computerized Tomography (CT Scan)

A CT Scan uses X-rays to view specific areas of your body. These scans use safe amounts of radiation to create detailed images, which can help your doctor to detect any problems. A heart, or cardiac, CT scan is used to view your heart and blood vessels. During the test, a specialized dye is injected into your bloodstream. The dye is then viewed under a special camera in a hospital or testing facility.

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Cardiac Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is a noninvasive test that uses a magnetic field and radiofrequency waves to create detailed pictures of organs and structures inside your body. It can be used to examine your heart and blood vessels, and to identify areas of the brain affected by stroke. Magnetic resonance imaging is also sometimes called nuclear magnetic resonance (NMR) imaging.

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Nuclear Medicine / Imaging

A multigated acquisition scan (also called equilibrium radionuclide angiogram or blood pool scan) is a noninvasive diagnostic test used to evaluate the pumping function of the ventricles (lower chambers of the heart). During the test, a small amount of radioactive tracer is injected into a vein. A special camera, called a gamma camera, detects the radiation released by the tracer to produce computer-generated movie images of the beating heart. The MUGA scan is a highly accurate test used to determine the heart’s pumping function.

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Electrophysiology Studies and Cardiac Ablations

Natural electrical impulses direct contractions of different muscles in your heart. This assists in appropriate blood flow. An electrophysiology study, often called an EP study, is a test used to evaluate your heart’s electrical system and to check for abnormal heart rhythms.

Cardiac ablation is a procedure that aims to correct heart rhythm problems (arrhythmias). This procedure uses radiofrequency or cryo energy to neutralize the tissue in your heart that is responsible for triggering an abnormal heart rhythm.

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Transesophagael Echocardiography

An echocardiogram uses soundwaves (ultrasound) to allow your doctor to see images of your heart. A transesophageal echo (TEE) test is a type of echo that uses a long, thin, tube (endoscope) to guide the ultrasound transducer down the esophagus, which is the “food pipe” that goes from your mouth to the stomach.

This echo lets your doctor see clear pictures of the heart without the ribs or lungs getting in the way. A transesophageal echo is used to check how well your heart’s valves and chambers are working.

Echocardiogram | Hospital Services at Central Montana Heart and Vascular Institute

Electrocardiogram (EKG/ECG)

An electrocardiogram is a test used to record the electrical activity in your heart. Your doctor will perform an electrocardiogram to monitor your heart’s health and detect any heart problems.

During the test, electrodes will be placed on your body and they will detect the electrical activity of your heart.

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Echocardiogram (Echo)

An echocardiogram (echo) is a test that uses high-frequency sound waves (ultrasound) to make pictures of your heart. The test is also called echocardiography or diagnostic cardiac ultrasound.

  • An echo uses sound waves to create pictures of your heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart.
  • A probe called a transducer is passed over your chest. The probe produces sound waves that bounce off your heart and “echo” back to the probe. These waves are changed into pictures viewed on a video monitor.
  • An echo can’t harm you.
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Stress Echo

A stress echo shows how well your heart and blood vessels are working During a stress echo you’ll exercise on a treadmill or stationary bike while the doctor measures your blood pressure and heart rhythm. When your heart rate reaches peak levels, a tech will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.

The stress echo may be used to diagnose problems with your heart, guide treatment decisions, or measure the effectiveness of treatment.

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Treadmill Stress Testing

A stress test shows how your heart works during physical activity. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. This test can show if the blood supply is reduced in the arteries that supply the heart

During the test, you may be walking on a treadmill. You will be hooked up to equipment that will monitor your heart rate, breathing, blood pressure, and an electrocardiogram, which is a test used to record the electrical activity in your heart. The stress test may be used to diagnose problems with your heart, guide treatment decisions, or measure the effectiveness of treatment.

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Cardiac Device Implantation

Implantable Loop Recorders

An implantable loop recorder is a small device inserted into your chest that records your heart rhythm. It can monitor the electrical signals of your heart continuously for several years.

Your doctor may recommend an implantable loop recorder to get more conclusive results if other tests fail. Some patients may have abnormal heartbeats (arrhythmias) or fainting spells intermittently. If these problems occur infrequently, a short test like an electrocardiogram (ECG or EKG) may not catch them. An implantable loop recorder allows for long-term heart rhythm monitoring, so these problems can be diagnosed effectively.


A pacemaker is a small battery-powered device that's placed under the skin in your chest to monitor your heart rhythm and help control your heartbeat particularly in patients that have slow heart rates. When the pacemaker detects a slow heart rate, it will send electrical impulses through wires that have been placed in your heart to stimulate your heart and increase your heart rate to normal. Implanting a pacemaker is a minor surgical procedure.

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Pacemaker | Hospital Services at Central Montana Heart and Vascular Institute

Implantable Cardioverter-Defibrillator

An implantable cardioverter-defibrillator (ICD) is a small battery-powered device placed under the skin in your chest to monitor your heart rhythm and detect abnormal life-threatening heart rhythms. An ICD can deliver electric shocks to the heart or to the chest to correct an abnormal heart rhythm. Your doctor may recommend an ICD if you have had or are at risk or having a life-threatening abnormal heart rhythm.

Some ICDs may also work as pacemakers.

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Implantable Cardioverter-Defibrillator | Hospital Services at Central Montana Heart and Vascular Institute

Transvenous ICD

A transvenous ICD is an ICD device that is attached to wires/leads that are placed directly into the heart. This type of ICD can also function as a pacemaker.

Subcutaneous ICD

A subcutaneous ICD is an ICD device that is placed solely under the skin with an ICD lead/wire and device surrounding the heart. Unlike general ICDs, this type of ICD does not function as a pacemaker.

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Biventricular Devices (BIV)/ Cardiac Resynchronization Therapy (CRT)

A biventricular device is a pacemaker or defibrillator that has an additional wire/lead that is placed on the surface of the heart through one of the cardiac veins to enhance heart function. This device is typically used to treat heart failure in patients with severely reduced heart function. This device allows for your heart chambers to squeeze (contract) in a more organized and efficient way.

Biventricular Devices | Hospital Services at Central Montana Heart and Vascular Institute