Services Offered at the Wausau and Rhinelander Clinics
Adenosine/Persantine or Dobutamine Stress Test
Carotid Duplex - Ultrasound of the Arteries in the Neck
Diagnostic Lab Testing
  General Chemistry
  Lipid Analysis
  Protime Clinic
ECG/EKG/Electrocardiogram
Echocardiogram - Ultrasound of the Heart
  Echocardiogram with Resynchronization - Wausau Only
Electrophysiologic (EP) Services - Wausau Only
Event Recorder - A Home Monitoring Device

Holter Monitoring
MUGA (Multi-Gated Acquisition)
Nuclear Stress Testing
Pulse Oximetry
Stress Echocardiogram - Stress test with ultrasound
Stress Test

Services Offered at Aspirus Wausau Hospital
Angioplasty (Percutaneous Transluminal Coronary Angioplasty or PTCA)
Cardioversions
Defibrillators and Defibrillator Monitoring
Diagnostic Catheterization
Directional Coronary Atherectomy (DCA)
Electrophysiologic (EP) Services
Pacemakers - Including Insertion and Monitoring
Stents
Tilt Table Exams
Transesophageal Echocardiogram (TEE)

In certain patients an Adenosine/Persantine or Dobutamine stress test will be ordered in place of exercising on a treadmill. This test is for patients who are unable to exercise adequately. Adenosine/Persantine and Dobutamine are drugs that produce an effect on the heart similar to that of exercise. The patient will have several electrodes placed on their chest to obtain an EKG or recording of their heart's electrical activity. Adenosine/Persantine or Dobutamine is injected over a 4-10 minute period followed by the injection of the radioactive material (or Cardiolite). The patient will then have a scan of their heart and its' vessels.

A carotid duplex is an ultrasound checking for blockages in the carotid arteries located in the neck. An ultrasound technologist performs the non-invasive carotid ultrasound by moving a small device over the arteries in your neck. This device captures ultrasound images of the arteries. The ultrasound is painless and usually lasts 30 minutes. The physician is not present for the exam.

The lab is open for phlebotomy and analytical services Monday through Friday. Blood for almost any assay can be collected by our laboratory when proper orders are presented. We will prcess the specimen(s) and facilitate their transport to the appropriate laboratory if the requested testing is not performed in the CVA laboratory. Appointments are required in most circumstance. Call 715-847-2611 or 800-441-4013 to schedule an appointment.

General Chemistry
Assays for kidney function, electrolytes and liver and cardiac enzymes are available at Cardiovascular Associates. All other chemistries are available through our relationship with Aspirus Wausau Hospital Regional Lab.

Lipid Analysis
Routine lipid analysis including total cholesterol, HDL (high density lipoprotein) cholesterol, measured LDL (low density lipoprotein) cholesterol and triglyceride are performed at Cardiovascular Associates. Advanced lipid analysis such as NMR lipoprotein profile (which measures HDL, LDL, particle size, distribution and number), Lp(a), homocysteine, apolipoprotein A1 and apolipoprotein B are available through our relationship with Liposcience, Inc. This advanced testing reveals added information regarding your risk and aids the physician in treating your condition.

Protime Clinic
Routine monitoring of oral warfarin (Coumadin) therapy. Cardiovascular Associates' protime clinic provides instant protime results. Recent updates of instrumentation and the use of highly sensitive reagents yields accurate and precise results. Coumadin/warfarin dose is based on the protime result and American Heart Association recommendations.

An EKG is a tracing of the electrical activity of the heartbeat. It evaluates abnormalities of the patient's heart rhythm.

Pictures/recording of the heart utilizing ultrasonic (sound) wave directed through the chest wall. Information regarding the position, structure and motion of the heart rate are obtained from this procedure. An ultrasound technologist performs the echocardiogram of your heart by moving a small device on the surface of your chest. This device captures images of your heart in motion. The test usually takes about 30 minutes. The physician is not present for this exam. This service is also offered at the Stevens Point clinic.

Echocardiogram with Resynchronization - Wausau Only
Cardiac resynchronization therapy involves the settings of a biventricular pacemaker to improve overall cardiac blood movement. Cardiac resynchronization therapy has been found to improve quality of life, and exercise capacity, as well as, improve patients with impaired left ventricular ( LV ) function, and functional class III/IV heart failure.

Dr. Fausto Devecchi is a specialist in Electrophysiology and sees patients in our Wausau and Rhinelander offices. To schedule an appointment, call our toll free # 1-800-441-4013.

The event recorder is a small portable EKG recorder that a patient can wear for extended periods of time of 2-4 weeks. Cardiovascular Associates offers 30 day event recording. Cardiovascular Associates utilizes 2 types of monitors, 1 that will automatically record abnormal rythms, and another monitor that is activated by the patient pushing a button upon experiencing any symptoms related to their heart rhythm. With both types of monitors, a recording is made of the patient's heartbeat. The patient then calls a toll free number and transmits the recorded rhythm strips over the telephone. Cardiovascular Associates receives a copy of them as they are sent and monitors them for potential arrhythmias.

The holter monitor is a small portable EKG recorder that a patient can wear for 24-48 hours.  The patient's heart rhythm is recorded continuously for the full 24-48 hour time period. The patient then returns the monitor to Cardiovascular Associates so the physician and review the recording for potential arrhythmias.

MUGA (multi-gated acquisition) is often ordered when a physician is concerned about how well the heart is actually pumping blood with each beat of the heart. This study involves a radioactive tracer which is used to label the patient's own red blood cells. These labeled red blood cells are reinjected into the patient and EKG and scan are performed. The scanner detects the red blood cells moving through the heart. The result is the calculation of an ejection fraction (or EF). This number is used to determine if the heart is satisfactorily pumping blood. The amount of time consumed for this exam is approximately 1 - 1-1/2 hours.

One-Day Cardiolite
A one-day Cardiolite Stress Test is a two-part test completed the same day. It involves using a radioactive substance to produce images of the heart. Patients are injected with the radioactive substance, or Cardiolite, then, a scanner photographs their heart and its' vessels. This is followed by a stress test which can be performed with or without the patient having to physically exercise on a treadmill (see Adenosine/Persantine Cardiolite Stress Test). Following the stress test, a second scan is performed and the two images are reviewed by a cardiologist. This one-day Cardiolite Stress Test consumes about 4-5 hours of the patient's time.

Two-Day Cardiolite
A two-day Cardiolite Stress Test is sometimes ordered by a cardiologist or referring physician for a certain population of patients. Day one of this procedure involves a stress test performed with or without the patient having to physically exercise on the treadmill (see Adenosine/Persantine Cardiolite Stress). During the stress test, the patient is injected with a radioactive substance, or Cardiolite. Following the stress test a scan is performed to photograph the patient's heart and its' vessels.
On the second day of this two day procedure, the patient returns and is injected again with the radioactive Cardiolite. This is followed by a resting scan of the heart. The images are then reviewed by a cardiologist. The amount of time consumed each day for the two-day Cardiolite Stress Test is 1-1/2 - 2 hours.

Used to determine the level of oxygen in a patient's blood.

This test combines the stress test and the echocardiogram. Pictures are taken before and after a stress test. The motion of the heart wall is evaluated. This gives an indication of the patient's risk for a heart attack. The exam comes in two parts, resting and exercise. EKG pads will be placed on your chest to monitor your heart rhythm. Then, like the echocardiogram, the sonographer obtains ultrasound images of your heart at rest. You will then walk on a treadmill to increase your heart rate and level of exertion. Once a certain level has been reached the sonographer will take another set of ultrasound pictures for interpretation. If you are not able to walk on a treadmill, you can be given a drug called Dobutamine. This take the place of the treadmill and is intended to have a similar effect on the heart. A physician or mid-level provider is present for the exam while the patient is on the treadmill. The Stress Echocardiogram or Dobutamine Stress Echocardiogram usually lasts for 1 hour.

A stress test is also known as a "graded exercise test" or GXT. This is a carefully controlled exercise session that allows the physician to evaluate the heart's response to stress/activity. The patient walks on a treadmill to try to get their heart rate up. A physician or mid-level provider is present for the exam.


Coronary angioplasty, also called "PTCA," is a procedure in which a catheter (flexible plastic tube) with a small balloon dilates, or "opens up," a blocked artery that supplies the heart muscle with blood. In contrast to open-heart surgery, PTCA can be done by making a small puncture in the skin and inserting the catheter into an artery in the leg or arm. Patients are awake during the procedure. Most go home within a day or two after it's over.

Cardioversion is a way to restore your heart's normal rhythm. When your heartbeat is irregular, medicine is often used first to try to correct the rhythm of your heart. If that doesn't work, cardioversion may be the next step. During this procedure, you are given a small, brief electric shock by a doctor. The shock helps your heartbeat become normal again. Cardioversion is most often done in a hospital. Before scheduling a cardioversion, your physician may ask you to take anticoagulants (blood thinners) for a few weeks. This helps prevent blood clots from forming and will be monitored closely by having frequent blood tests (INR) until the time of the cardioversion.

Defibrillators are used to monitor your heart rhythm. If it senses an arrhythmia, it will deliver therapy to your heart. Each defibrillator is programmed for the patient's specific needs. The device is implanted in your chest. One or more leads, which are implanted in your heart, are connected to the device. This device delivers an electrical shock to the heart to restore an extremely rapid and irregular heart rate to normal rhythm.

A cardiac catheterization is a procedure that examines the heart. During this procedure, a physician can measure pressures inside the heart, take pictures of the arteries bringing blood to the heart, and assess how well the heart is pumping. In most cases, patients come to the hospital in the morning, undergo the cardiac catheterization procedure, and leave later in the afternoon. Such procedures are called outpatient procedures. Whether you undergo the procedure as an outpatient or inpatient, you'll first meet with the doctor who'll do the procedure and/or a member of the catheterization team. The doctor or catheterization team member will explain why and how the procedure will be done and its risks.

Whether you'll be an outpatient or an inpatient, you'll be told not to eat or drink anything the morning of the procedure. Your doctor will want you to take certain medications (such as aspirin and other heart medicines) before your procedure. But he or she may not want you to take other medicines (such as certain diabetes medications, "water pills" or blood-thinning medicines). Make sure you know which medicines to take and avoid before your catheterization.

In directional coronary atherectomy a specialized small cutting device is threaded to the blocked area. The DCA device then uses a rotating cutter to "shave off" pieces of the blockage. After part of the blockage has been removed, the artery is usually opened more with balloon angioplasty. A stent is often inserted after that.

Dr. Fausto Devecchi performs A Flutter Ablations, implantations of pacemakers, Bi-Ventricular Pacemakers, and AICD (Automatic Implantable Cardioverter Defibrillator) procedures.

If you have a slow and often irregular heartbeat, or if your heartbeat is sometimes normal and sometimes too fast or too slow, blood isn't pumped around your body well. In that case your doctor may recommend an artificial pacemaker. A pacemaker will make your heart beat more regularly. That will help ensure that enough oxygen and nourishment get to your body's cells.

An artificial pacemaker system has two parts: a generator and wires (leads). The pacemaker generator is a small battery-powered unit. It produces the electrical impulses that start your heartbeat. The generator is implanted under your skin through a small incision.

The generator is connected to your heart through tiny wires that are implanted at the same time. The impulses flow through these leads to your heart and are timed to flow at regular intervals just as impulses from your heart's natural pacemaker would.

Stents are now used in most angioplasties. Stents are small, metal, spring-like devices about the size of a spring in an ink pen. The stent is implanted in the coronary artery to reduce the risk that a treated blockage will "grow back."

A tilt table study is done for diagnostic and drug therapy evaluations. A tilt table study is performed with the use of a special table called a "Tilt Table" under controlled conditions. The studies are done in an attempt to induce the symptomatic fainting (syncopal) episode and/or heart rhythm changes (arrhythmia) under controlled conditions for the purpose of diagnosis and therapy evaluations.

A Transesophageal Echocardiogram or TEE is another type of ultrasound to obtain images of the heart as it pumps. During the TEE, the physician passes a flexible ultrasonic probe into the esophagus. The probe is advanced to various lengths to obtain different images of specific areas of the heart. A TEE is performed when more detailed information is needed to: diagnose heart valve disease, locate blood clots, evaluate the functioning of repaired or replaced heart valves and evaluate heart function. It is performed on an outpatient basis at Aspirus Wausau Hospital.