Diagnostics and therapy cardiology and interventional cardiology

In cardiology/interventional cardiology, we specialize in the following diagnostic and therapeutic measurements:

• echocardiography
• coronary angiography (catheter-assisted)
• coronary intervention (catheter assisted)
• electrophysiological examination of the heart, cardiac ablation/electrical cautery
• outpatient implantation of miniature sensors
• device maintenance, special aftercare (pace maker, implanted cardioverter/defibrillator)
• MRI for patients with pacemaker, cardioverter/defibrillator
• stress MRI/cardiac MRI

Coronary angiography (catheter-assisted)

During coronary angiography, we guide a catheter to the heart via an arterial access at the wrist in order to examine coronary arteries. Like other angiographic examinations, the correct position of the catheter is controlled by using X-ray technique. By applying a contrast agent, blood vessels become visible.

After coronary angiography (catheter-assisted)

After coronary angiography, there is no confinement to bed. Patients are mobile directly after the procedure, reducing further complications, and stay for one night at the clinic.

Two to three days after coronary angiography, all daily activities are possible. Only a small bruise and swelling at the wrist are visible for a few days.

Coronary intervention (PCI)

Coronary angiography (catheter-assisted) can be followed by a percutaneous coronary intervention (PCI). This procedure is the only treatment option to remove stenoses (narrowness) of the coronary arteries.

How is coronary intervention (PCI) performed?

During coronary intervention (PCI), a specific catheter suited to coronary intervention is guided to the heart via an arterial access, through which a very thin coronary guide wire is inserted to the stenotic (narrowed) artery. Afterwards, a balloon dilates the artery and a stent or a bioresorbable vascular scaffold is implanted. Bioresorbable materials resolve completely within months or a few years. This way, no artificial material remains in the heart.

After coronary intervention (PCI)

Thanks to the access via the artery of the wrist (radial artery), an immediate mobilization without confinement to bed is possible. Due to the implantation of scaffolds/stents, drugs have to be taken for a few months that prevent a stent thrombosis. Normally, acetylsalicylic acid (Aspirin or ASS) is combined with another antiplatelet drug, resulting in a mild increase of bleeding tendency.

Device maintenance, special aftercare (pace maker, implanted cardioverter / defibrillator)

Patients with a pacemaker or an implantable cardioverter/defibrillator (ICD or defibrillator) need device maintenance and special aftercare by using a specific device testing the pacemaker or implantable cardioverter/defibrillator. Modern devices make telemedicine remote monitoring possible and, thus, an appointment at our department is not necessary anymore.

Data retrieval/programming

The collected data of the pacemaker or cardioverter/defibrillator can be relayed by a transmitter at our department. This way, we do not only test the integrity but are also able to analyze and evaluate the collected data since the last data retrieval.

Visiting the department for data retrieval purposes is often not necessary anymore if modern devices are used. Then a remote data retrieval is possible no matter if you are at home or on the road. This kind of aftercare and device maintenance is also recommended by national and international medical societies.

Echocardiography

Echocardiography is an ultrasound examination of the heart that can also be three-dimensional. It is a painless, non-invasive depiction of the heart, its function and the structure of the ventricles.

Indication echocardiography

Echocardiography is mainly used if the presence of coronary artery disease (CAD), diseases of the heart valves or palpitations/cardiac arrhythmia are suspected.

How is echocardiography performed?

A painless, non-invasive ultrasound examination of the heart, echocardiography can be undergone while lying on a gurney or in bed. You can see everything and can directly receive explanations of the structure and function of your heart.
An echocardiographic stress test is the ultrasound examination of the heart under a physical stress condition like riding a stationary bicycle while being examined.

Advantages echocardiography

Echocardiography is painless and non-invasive. Without X-rays or a huge efforts, this ultrasound examination gives immediate insight into problematic areas of the heart.

Contraindication echocardiography

There are no contraindications (reasons to withhold this medical procedure) to echocardiography.

Electrophysiological examination of the heart, cardiac ablation / electrical cautery

During the electrophysiological examination of the heart, the cardiac ablation/electrical cautery, veins of the groin are punctured and used as a passage to guide at least two catheters to the atrium/ventricle of the right side of the heart. Afterwards, electrical stimulators create impulses that generate additional heartbeats (extrasystoles) leading to cardiac arrhythmia (irregular heartbeat). The area causing the irregular heartbeat is then cauterized via the catheter transmitting radiofrequency waves to the tissue of the heart muscle. By heating a specific area this way, it becomes electrically harmless. The procedure lasts about 30-45 minutes. At the end of the electrophysiological examination of the heart or the cardiac ablation/electrical cautery, the catheters are removed and a tourniquet is applied for 4 hours.

After the electrophysiological examination of the heart, cardiac ablation / electrical cautery

One day after the electrophysiological examination/cardiac ablation, patients are released from the clinic. They must take it easy for at least 2-3 days and refrain from physical exercises and carrying heavy loads. A medication that lasted until the ablation can be reduced gradually until it is not necessary anymore.

MRI for patients with pacemaker, cardioverter / defibrillator

An MRI examination of patients with pacemaker (PM) or cardioverter/defibrillator (ICD) necessitates a special care. Vital functions of the body and the function of pacemaker or cardioverter/defibrillator have to be monitored during the MRI examination.

How is the MRI examination with pacemaker, cardioverter / defibrillator performed?

Prior to the MRI examination of patients with a pacemaker or a cardioverter/defibrillator (ICD), pacemakers and cardioverters/defibrillators are tested and temporarily re-programmed for the MRI examination. Directly after the MRI examination, pacemakers or cardioverters/defibrillators are tested again and re-programmed to grant normal functioning.

Advantages of MRI examination with pacemaker, cardioverter / defibrillator

Only a few specialized centers are able to safely and competently carry out MRI examinations for patients with pacemakers or implantable cardioverters/defibrillators (ICD).

Contraindications MRI examinations with pacemaker, cardioverter / defibrillator

Patients with pacemakers or implantable cardioverters/defibrillators (ICD) are only allowed to undergo an MRI examination if this kind of examination is absolutely necessary.

Outpatient implantation of miniature sensors

The outpatient implantation of miniature sensors above the left chest muscle (pectoral region) serves diagnostic purposes of undetected cardiac arrhythmia (irregular heartbeat) as well as causes of an apoplectic stroke.

How is outpatient implantation of miniature sensors performed?

During the outpatient implantation of miniature sensors, the skin of the left chest muscle (pectoralis major muscle) is locally anesthetized and the miniature sensor is implanted. This procedure takes about 8-10 minutes. The drug treatment with anticoagulants (blood thinners) has to be stopped if necessary.

Advantages outpatient implantation of miniature sensors

The outpatient implantation of miniature sensors is a very good means to examine unclear palpitations or apoplectic stroke.

Contraindications outpatient implantation of miniature sensors

There are no contraindications (reasons to withhold this medical procedure) to the outpatient implantation of miniature sensors.

Stress MRI / cardiac MRI

Stress MRI/cardiac MRI is an MRI examination of the heart that is carried out in case of special questions and if patients are suspected to suffer from coronary artery disease (CAD). In cooperation with the radiology department of Beta Klinik, we can offer you an MRI examination suited to your heart.

How is the stress MRI / cardiac MRI performed?

The stress MRI/cardiac MRI is carried out while lying on the back. Drugs are then administered to stimulate the heartbeat and a stress situation.

Advantages stress MRI / cardiac MRI

The stress MRI/cardiac MRI is a non-invasive examination of the heart, using state-of-the-art technology to ensure a detailed depiction of the most important structures of the heart and coronary arteries, without X-ray exposure.

Contraindications stress MRI / cardiac MRI

Patients with pacemakers or implantable cardioverters/defibrillators (ICD) are only allowed to undergo an MRI examination if this kind of examination is absolutely necessary.