Emphases and goals
Reopening of coronary arteries in acute myocardial infarction
The Department of Cardiology, IKEM focuses on the treatment of acute coronary syndromes, particularly of acute myocardial infarction. The main goal is to normalise blood flow as soon as possible and thus, minimalize damage to the myocardium. Immediate reopening of the affected coronary artery is almost in all cases followed by implantation of the stent (metallic support that prevents recoil of the tissue). Similar interventions are used in patients with angina pectoris to improve blood flow into the muscle by dilating stenoses of the coronary vessels. The technology required for cardiac catheterization and percutaneous intervention is available in two modern catheter laboratories round the clock.
Catheter ablation of cardiac arrhythmias
One of the main areas of the interest in the Department of Cardiology, IKEM is catheter-based treatment of various cardiac arrhythmias – the so-called catheter ablation. Two state-of –the-art electrophysiological laboratories equipped with 3-D mapping systems and intracardiac echocardiography allow catheter ablation of any arrhythmia, including atrial fibrillation, ventricular tachycardias or tachycardias after previous surgical correction of congenital heart disease. In majority of cases, radiofrequency electrical current is used to destroy the tissue responsible for arrhythmia initiation of maintenance. However, cryoenergy and other technologies are available in this centre. The Department of Cardiology, IKEM is also one of the several world-known centres with experience in the use of robotically-navigated catheter ablation of atrial fibrillation. Robotic navigation allows more precise and remote manipulation of the catheter inside the heart and improves efficacy of the procedure.
Prophylactic implantation of cardioverter-defibrillators in high risk patients
Patients after previous resuscitation for cardiac arrest or those at high risk of sudden death due to malignant arrhythmias are indicated for implantation of cardioverter-defibrillator (ICD) – the device that monitors heart beat and rectifies malignant arrhythmias if they occur. Implantation of these devices improves prognosis of patients significantly. All patients are then followed up in outpatient clinic and some devices allow even long-distance transtelephonic monitoring. Historically, the Department of Cardiology, IKEM is the first centre in Central and Eastern Europe where such device was implanted back in 1984. It remains one of the largest implantation centres in the region and employs modern operation theatre for this purpose.
Management of advanced heart failure
The Department of Cardiology, IKEM is one of the leading centres involved in evaluation and management of patients with various forms of heart failure – situation when the heart is not able to pump adequate amount of blood to fulfil the requirements of the body. Heart failure unit allows monitoring and treatment of these patients who often become candidates for heart transplantation. One of the therapeutic options could be implantation of device for cardiac resynchronization therapy – pacemaker or ICD that is able to resynchronize contractions of both ventricles and optimize performance of the failing heart. The Department of Cardiology, IKEM is one of the largest centres with experience in this therapy. Patients with more advanced heart failure could be indicated for implantation of mechanical heart support (artificial heart). Outpatient section allows long-term follow up of many patients with chronic heart failure.
Diagnostics and treatment of pulmonary arterial hypertension
The Department of Cardiology, IKEM is one of the two centres in the Czech Republic that are approved for treatment of patients with severe pulmonary arterial hypertension (increase of blood pressure in pulmonary arterial tree). These patients have adverse prognosis without treatment and modern drugs can lead to significant improvement of quality of life and prolongation of survival. Such therapy requires advanced diagnostic capabilities and monitoring of the effect of drugs using repeated right heart catheter studies (measurement of blood pressure in pulmonary artery through thin catheter).
Noninvasive diagnostics of cardiac diseases
Modern diagnostic methods are used at the Department of Cardiology, IKEM for precise diagnosis of various cardiac diseases and assessment of their severity. Echocardiography is one of the most important diagnostic tools. Six state-of-the-art echocardiographic machines allow wide spectrum of echocardiographic techniques, including tissue Doppler imaging and 3D echocardiography. In addition, exercise testing, spiroergometry and/or various forms of ambulatory monitoring of heart rhythm are available. In cooperation with the Department of Radiology in IKEM, multislice CT and/or magnetic resonance imaging of the heart is often used to complete diagnostic approach.
