Written by Christodoulos Stefanadis, Professor of Cardiology University of Athens, Professor of Cardiology Yale School of Medicine, Director of Athens Heart Center, Athens Medical Center
Cardiology is a modern specialty rapidly developed and shifted regarding its methods and scope. Standard "Athens Heart Center" in Athens Medical Center aims at covering the entire spectrum of modern developments in cardiology while aiming at producing and promoting research and educational work.
The main features of Athens Heart Center is the Department of Cardiology, the Catheterization Laboratory, The Electrophysiology Laboratory - Pacing and the improved innovative Diagnostic Laboratories and Units, which cover the entire spectrum of cardiology with the most modern approach.
The Interventional Cardiology Laboratory has two modern rooms of Catheterization Laboratory. The contemporary approach to invasive treatment of coronary artery disease requires performing both angiography and angioplasty with stent placement, by accessing the arm and the radial artery, achieving patient’s mobilization and discharge on the same day.The Cardiology Clinic is a fully equipped and organized cardiology clinic, with excellent medical and nursing personnel, who are at the disposal of patients at any time, ready to manage any acute or chronic cardiac incident. The excellent patient monitoring is facilitated by the telemetry systems and the ongoing education of nursing staff.
Main commitment and mission of the Laboratory is to conduct primary angioplasty any time and day, ie, direct stenting of the occluded artery in case of acute myocardial infarction with excellent results. The method is internationally established as the best treatment of acute myocardial infarction, it requires readiness and experienced staff and is carried out in very few centers in our country in a 24-hour basis.
High priority is to promote the transcatheter aortic valve implantation program (TAVI), where recent studies demonstrate the efficacy of percutaneous approach of structural heart disease, often superior to the open-heart surgical approach. In the Laboratory of Electrophysiology and Pacing of Athens Heart Center,
entire range of electrophysiology and pacing procedures is performed. The laboratory is available all days and hours of the week, throughout the year, for permanent pacemaker implantation systems in patients, where the pacemaker implantation is urgent.
Since October 2015, Athens Heart Center is the first center in Attica, and Athens Medical Center the only private hospital, where implants without leads of the most advanced pacing technology of Micra pacemakers will be performed, in the largest international clinical study. The innovative device is implanted through the femoral vein, it is 93% smaller than existing pacemakers and minimizes complications as it has no leads or does not require the creation of a "pocket" on the chest, making it the epitome of nanotechnology.
The implanted defibrillator is now an established treatment that prevents sudden death in patients with heart failure and in patients with myocardial infarction, dilated cardiomyopathy, hypertrophic cardiomyopathy and electrical heart diseases. At the same time, one in three patients with heart failure also require biventricular implant systems with the defibrillator. The defibrillator prevents the occurrence of sudden cardiac death, while the biventricular pacemaker, to appropriately selected patients, re- synchronizes significantly the cardiac contraction, improving cardiac function and the clinical condition of the patient.
Atrial fibrillation that needs a holistic medical approach with a proper selection of anticoagulation, antiarrhythmic and invasive treatment and management of comorbidities in conjunction with the relevant specialties. The selection of patients for atrial fibrillation ablation is performed by the first in Greece Special Unit for Atrial Fibrillation.
The AF ablation procedures are performed both with the current method of cryoablation and with the help of the latest electroanatomical mapping systems, which also provide an objective assessment of each cauterization (CARTO 3, Smart-touch). In the Laboratory of Electrophysiology and Pacing of Athens Heart Center, the efficacy of these operations exceeds 80%.
Experience and special interest in the management of patients with ventricular arrhythmias within the Arrhythmia Unit is also adequate. Patients are selected based on the appropriate clinical- laboratory examinations and they will undergo safe and effective endocardial and epicardial ablations of ventricular tachycardias. Arrhythmia unit aims at the selection of patients with supraventricular arrhythmias and bundles for ablation procedures, often achieving final cure and free of any medication.An innovation of Athens Heart Center is the improved, innovative Diagnostic Laboratories and Units. In the Echocardiology Laboratory a three-dimensional echocardiography using modern techniques and transesophageal echocardiography are performed at any time, while Dobutamine Stress Echocardiography for the diagnosis of coronary heart disease and Stress echo using a bicycle ergometer for valvular heart disease investigation and assessment of myocardial viability are of unique experience.
In the Laboratory of Fatigue, Arrhythmias Control and Pressure Measurements of Athens Heart Center, we conduct fatigue test, cardiopulmonary exercise test on bicycle ergometer, a tilt-table test to investigate syncope, Holter rhythm with the possibility of sudden death risk assessment in patients with structural heart disease, and a 24- hour blood pressure monitor (pressure Holter) in connection with the Hypertension Unit. It is also possible to carry out tests and adjustment of pacing and defibrillation systems.
The Units of "Athens Heart Center" are designed for the systemic, holistic and contemporary management of the entire range of cardiovascular diseases, staffed by the most specialized cardiologists.
In the Hypertension Unit, a full diagnostic and laboratory testing (pressure Holter, heart triplex, albuminuria measurement, assessment of peripheral vessels) is performed. Emphasis is given to the investigation of secondary hypertension and in selecting patients for renal artery angioplasty, removal of endocrine tumors and sleep apnea treatment. At the same time, refractory hypertension cases are thoroughly investigated and patients are selected for renal artery denervation .
In the Cardiomyopathy and Congenital Disorders Unit patients and families with diagnosis of congenital cardiovascular disease are monitored, while pre-activity and pre-sport activity control is also carried out.
In the Coronary Disease Unit, an appropriate diagnostic disease approach is performed in cooperation with the specialized Echocardiology Laboratory and performing stress echo, while a relevant optimal invasive and non-invasive treatment is applied.
In the Syncope Unit, an appropriate diagnostic approach is done using rhythm Holter, heart triplex, tilt-table test and implantation of loop recorders, prognosis of patients is assessed and patients suitable for implantation of pacemaker and defibrillator systems are selected.
In the Pregnancy Heart Disease Unit, pregnant women who develop gestational hypertension are monitored in cooperation with gynecologists, as well as pregnant women with preexisting heart problems.
In Metabolic Disease and Pathological Condition Unit, patients with diabetes mellitus, metabolic syndrome, morbid obesity and special pathological metabolic diseases are monitored and their cardiac risk is assessed.
The Units and the Laboratories of the Standard Athens Heart Center, in addition to the best and innovative health services provided at clinical level, aims at providing both research results by the internationally recognized scientific personnel and educational work, either at undergraduate level on student education or providing high quality clinical training to cardiology residents. The ultimate goal is to help Athens Heart Center to develop in a special education center for cardiologists across Europe in specific innovative techniques ensuring its autonomy.