What is Cardiac Electrophysiology?
Cardiac electrophysiology is the study of the heart’s electrical system. The term “electrophysiology study” or “EP study” applies to any procedure that requires the insertion of an electrode catheter into the heart. Electrode catheters are long, flexible wires that transmit electrical currents to and from the heart.

Some electrophysiology studies are done to diagnose abnormalities (see Heart Rhythm Problems and Conditions ), while others are done to access the heart for treatment or correction of certain conditions, such as Pacemaker Implantation, ICD Insertion, or Cardiac Ablation.

Electrical Impulses Keep Your Heart Pumping
The heart’s electrical system controls the rhythmic contractions that keep the blood pumping and circulating throughout your body. These electrical impulses are controlled by the sinus node, a group of specialized cells that act as the heart’s natural pacemaker.

Why is good blood circulation important?
Blood is rich with the oxygen and nutrients that keep our cells alive and functioning, so a strong circulation of blood throughout the body is a vital component of good health. Electrical signals from the sinus node keep the heart contracting at a healthy pace, which controls the rate of blood that is pumped to nourish and energize the body.

How does the heart control blood circulation?
The heart is a muscular pump that serves as the master control station for blood circulation. The heart is divided into four chambers. The upper chambers are called the right and left atrium, and the lower chambers are called the right and left ventricle.

Blood from all parts of the body drains into the right atrium, passes through a valve and reaches the right ventricle. The right ventricle contracts with each heartbeat and blood is pushed into the lungs, where it gives off carbon dioxide, takes up oxygen, and returns via the pulmonary veins to the left atrium. During relaxation of the left ventricle, the blood passes from the left atrium to the left ventricle where, with each heartbeat, it is ejected through the aortic valve into the aorta. From the aorta, blood flows through the circulatory system to nourish the organs and tissues of the body.

Why is the heart’s electrical system so important to good blood circulation?
The heart’s electrical system transmits signals throughout the heart that keep it pumping at a healthy pace. Beginning in the sinus node, these electrical impulses then travel through pathways of the heart’s upper chambers, which causes them to contract and squeeze blood into the ventricles. Electrical impulses then spread to the atrioventricular node, or AV node, which buffers them before they pass through the ventricles. Specialized muscle fibers running through the ventricles distribute the impulses that cause them to contract and pump blood.

How do problems with the electrical system affect blood circulation?
When there is a problem with the heart’s electrical system, its pumping power is diminished and blood does not circulate effectively. The body does not get the full supply of oxygen that it needs to thrive. This can cause irregular heart rhythms and conditions.

Coronary Calcium Scoring

Coronary Calcium Scoring

What is Coronary Calcium Scoring?
Coronary heart disease (atherosclerosis) is the nation’s leading killer, and is responsible for more deaths than all types of cancer combined. Every year, more than one million Americans will suffer a heart attack. More than 50% of the patients suffering their first heart attack this year will have no prior symptoms before their first coronary event or death.

Coronary calcium scoring (CCS) is a proven, non-invasive method that can directly identify plaque buildup in the coronary (heart) arteries. The coronary calcium scoring screen is a CT scan that only provides a small fraction of the dose of a routine chest CT. This test has been performed on tens of thousands of patients in the United States. More than 100 scientific articles proving the validity of this test have been published since 1998. In 2006, an international panel of leading cardiologists endorsed this technique.

Who should consider a Coronary Calcium Scoring Screening?
Useful in patients with risk for heart attack by other risk assessment methods. Calcium scoring has also been shown to be accurate in men and women in all age groups. Useful in asymptomatic patients with intermediate risk for heart attack (10%-20%-10 year risk of developing cardiovascular disease based on Framingham Risk Score.) Knowing your calcium score can help your provider direct medications to modify cardiovascular risk factors and help patients improve compliance with heart healthy habits.

Does Calcium Scoring predict a patient’s risk of heart attack or death?
Yes. Calcium scoring predicts a patient’s risk of heart attack or death over five years with higher sensitivity than stress testing or any other known risk factors. An individual with a calcium score in the highest quartile for age (greater than 75th% rank) is more than 6 times likely to have a heart attack than a patient with no coronary calcium. The risk of death in an individual with a calcium score greater than 1000 is more than 12 times higher than that of an individual with a calcium score less than 10.

Patient Prep – What do I need to know before my screening?
Refrain from caffeine for 24 hours before your exam. This will help maintain a slow steady heart rate, improving the quality of your examination. Typically, no medications and no IVs are needed for this examination. You will lie on your back in the scanner. X-rays of your heart will be made during a single breath hold. The examination should be completed within 5–10 minutes. Your examination will then be quality controlled for accuracy by a board certified radiologist, and your score calculated by computer analysis. The result will be sent to your physician.

How do I schedule a Coronary Calcium Scoring Screening?
Your physician will need to contact Central Scheduling at (828) 268-9037.

How much will it cost?
The cost of the procedure is $200.00. The technical portion is $125.00 and the professional portion is $75.00 Some insurance carriers will pay for this screening, but we require full payment for this exam at time of service. Upon request Watauga Medical Center will provide a UB billing form for the technical component so you can submit it to your insurance provider for reimbursement.

Cardiac and Pulmonary Rehabilitation

Cardiac and Pulmonary Rehabilitation

The Appalachian Cardiopulmonary Rehabilitation Program (ACRP) is a physician referred medically supervised exercise program. Each patient is provided with multidisciplinary care from several healthcare professionals that include a medical doctor, exercise physiologist, registered nurse, respiratory therapist, behavioral health specialist, and clinical dietician.

The Cardiac Rehabilitation program is designed to restore the cardiac patient to an optimal physical, vocational, recreational and emotional status with the potential for prevention of further disease progression. The patients are strongly encouraged to make various lifestyle changes for the purpose of reducing coronary risk and improving quality of life.

The Pulmonary Rehabilitation program is designed to improve lung function, reduce symptom severity and improve quality of life. It is an important part of the management and health maintenance of people with chronic respiratory disease who remain symptomatic or continue to have decreased function despite standard medical treatment.

A patient who has, or has had one or more of the conditions below may be an appropriate candidate for the program:

Cannon Memorial Hospital

(828) 737-7069 | Fax (828) 737-7509

Watauga Medical Center

(828) 268-9054 | Fax (828) 268-9055

Conditions for Cardiac Rehabilitation

  • PTCA / Stent
  • Acute Myocardial Infarction (heart attack) within last 12 months
  • CABG (Coronary Artery Bypass Grafting)
  • Heart Valve Repair / Replacement
  • Stable Angina Pectoris (chest pain) with current symptoms
  • Heart / Heart-Lung Transplant
  • Heart Failure-Chronic (systolic), EF <35%, NYHA Class II-IV
  • Peripheral Arterial Disease (PAD with symptoms)
  • LVAD
  • Other Cardiac Diagnoses would be based on the patient’s individual insurance approval

Conditions for Pulmonary Rehabilitation:

* Patient must have recent (within 1 year) PFT/Spirometry completed prior to starting rehab

  • COPD (Chronic Obstructive Pulmonary Disease) Moderate to Very Severe
  • Asthma
  • Status Asthmaticus
  • Lung Transplant
  • Restrictive Lung Disease
  • Pulmonary Fibrosis
  • Chronic bronchitis
  • Emphysema
  • Other Pulmonary Diagnoses would be based on the patient’s individual insurance approval

Comprehensive Evaluation:

A comprehensive evaluation by the ACRP team and/or patient’s physicians and may include:

  • Exercise testing
  • Coronary risk factor profile
  • Nutritional evaluation
  • Coping skills evaluation
  • EKG
  • Medical history review
  • COPD Risk Assessment
  • Sleep Apnea Risk Assessment
  • Fall Risk Assessment
  • Blood Pressure
  • Telemetry Monitoring

Cardiac & Pulmonary Rehabilitation Therapy Sessions Include:

Support: A group with which to share success and encouragement, and in turn, be encouraged.

Clinical: Sessions will include supervision and monitoring by a team of multidisciplinary healthcare professionals. This team may include a Supervising physician, registered nurse, clinical exercise physiologist, respiratory therapist, clinical dietitian, and health coach specialist from our Behavioral Health department. These team members are available as resources to help teach, guide, and take the best possible comprehensive care of you on your journey of recovery. They are here to advocate for you as needed regarding other aspects of your care which may include communication with your other healthcare providers regarding keeping you as up to date as possible with your needs.

Exercise: Activity to improve heart and lung function, as well as increase muscular strength. Heart rate, blood pressure, oxygen saturation, EKG and blood glucose are monitored during the exercise sessions.

Education: Education is provided to patients about how to better cope with their disease, how to modify their lifestyle, and reduce risk factors for their disease.

For more information, call:

  • Cannon Memorial Hospital, Sloop Medical Building– (828) 737-7069 Fax (828) 737-7509
  • Watauga Medical Center, Broyhill Wellness Center– (828) 268-9054 Fax (828) 268-9055


Paul H. Broyhill Wellness Center

Broyhill Wellness Center

232 Boone Heights Drive
Boone, NC 28607
Phone: (828) 266-1060
Fax: (828) 386-2664
Visit Website

Cannon Memorial Hospital

434 Hospital Drive
Linville, NC 28646
Phone: (828) 737-7000
Fax: (828) 737-7401
Visit website

Location: Watauga Medical Center

Watauga Medical Center

336 Deerfield Road
Boone, NC 28607
Phone: (828) 262-4100
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If you would like to speak to someone about our services, please let us know!

American Heart Association (AHA) Training Center

American Heart Association (AHA) Training Center

The American Heart Association (AHA) Training Center at Appalachian Regional Healthcare System (ARHS) serves healthcare providers as well as people from the community by providing training in basic and advanced life support.

Training Center Contacts

To schedule a CPR class, contact the ARHS AHA Training Center at (828) 268-8971 or email ahacoord@apprhs.org

Training Center Links

The following links are posted to assist healthcare providers and the community. If you have any questions regarding any of this material, please contact the Training Center Coordinator

American Heart Association
American Heart Association Courses online
AHA Instructor Network

Mission and Goals of the American Heart Association

The American Heart Association’s mission is to build healthier lives, free of cardiovascular diseases and stroke. Initiatives towards this mission include:

  1. Go Red for Women
  2. Power to End Stroke
  3. Go Red Por Tu Corazon
  4. My Heart My Life

Appalachian Regional Healthcare System Training Center supports the AHA mission and goals through administrative, educational, and quality assurance support of its AHA instructors. The ARHS Training Center also supports the healthcare system’s mission and vision through the provision of quality AHA classes to healthcare professionals, to the community, and by educating and informing the AHA instructors on new skills or AHA programs.