Atrioventricular block diagnosis and conservative treatment in Hospital Cologne-Merheim

About the department

The Department of Cardiology, Angiology and Endocrinology at the Hospital Cologne-Merheim offers the full range of medical services for patients with heart, vascular, and endocrine diseases. In the field of cardiology, special attention is paid to interventional catheter-based procedures, treatment of heart rhythm disturbances (arrhythmias), emergency care for acute coronary syndrome, and cardiac imaging diagnostics. The department's angiologists have all the necessary resources for the diagnostics and treatment of arterial, venous, and lymphatic vessel diseases. The primary clinical focus of the department's endocrinologists is the treatment of type 1 and type 2 diabetes mellitus, as well as other types of diabetes mellitus and endocrinopathies. The department houses two state-of-the-art Cardiac Catheterization Laboratories where numerous effective diagnostic and therapeutic interventional procedures are performed. The department also widely uses drug therapy with pills, infusions, and injections. The medical team, consisting of 32 staff members, takes care of the health of patients. The specialists are always open to dialog with their patients, striving to take into account their individual needs and wishes. In 2021, a new building for the Section of Cardiology was put into operation. It is designed in accordance with the "Cardiology of the Future'' concept, which means that the very latest technologies and concepts of medical care for patients with heart disease are implemented here. The department is headed by Prof. Dr. med. Axel Meissner.

Special attention in the clinical practice of the department's cardiologists is paid to interventional diagnostic and therapeutic procedures with the use of catheter-based techniques. The specialists have two modern Cardiac Catheterization Laboratories with equipment for intravascular ultrasound scans, fractional flow reserve assessment, intravascular optical coherence tomography (OCT), right heart catheterization, and other tests. Cardiac Catheterization Laboratories are also adapted for performing therapeutic interventional procedures, which often serve as an alternative to traumatic surgery requiring a thoracotomy. The most popular heart interventional procedures include percutaneous transluminal coronary angioplasty followed by stent implantation for coronary stenosis and obstruction and closure of atrial septal defects, patent foramen ovale, and left atrial appendage using special occluders. The procedures are performed through a puncture in the femoral, subclavian, or ulnar artery with special miniature catheters under imaging guidance and local anesthesia.

The department's cardiologists also specialize in the diagnostics and treatment of heart rhythm disturbances (arrhythmias), such as tachycardia, bradycardia, atrial fibrillation, and paroxysmal supraventricular tachycardia. The hospital is certified as a Competence Center for Arrhythmias by the German Society of Cardiology (DGK). In many cases, normalizing the heart rhythm can be achieved with drug therapy, but in complex cases, catheter-based interventions such as the placement of pacemakers or implantable cardioverter-defibrillators may be required. The department also has vast experience in cardiac resynchronization therapy, which is indicated for patients with severe heart failure and bundle branch block.

The department's range of medical services is complemented by the diagnosis and treatment of diseases of the vascular system. Doctors provide medical care to patients with occlusive peripheral arterial disease, varicose veins, deep vein thrombosis, lymphoedema, and other pathologies. The department houses advanced diagnostic facilities where doctors perform Doppler ultrasonography, color duplex sonography, oscillography, venous occlusion plethysmography, light reflection rheography, capillary microscopy, percutaneous measurement of arterial blood oxygen saturation, and the placement of a device for 24-hour blood pressure monitoring. More than 7,500 angiography procedures are performed in the department every year. The department's specialists also provide conservative treatment for patients with vascular diseases. In complex cases, interventional radiologists and vascular surgeons may be involved in the therapeutic process. They cooperatively study clinical data and elaborate the most effective treatment regimen for the patient.

The medical facility also offers treatment for endocrine disorders. The primary focus for physicians is the management of patients with type 1 and type 2 diabetes mellitus. More than 1,000 inpatients with diabetes mellitus undergo treatment in the department annually, and about 700 patients with this disease from other departments of the hospital receive consultations here. Diabetes mellitus is an incurable disease, so the task of doctors is to compensate for the condition through diet, insulin, oral hypoglycemic medications, and physical activity. The department regularly organizes individual and group lifestyle modification training for patients with diabetes mellitus, enabling them to acquire the necessary knowledge for self-monitoring of the disease.

The department's therapeutic options include:

• Cardiology
  • Drug therapy
  • Interventional catheter-based procedures
    • Percutaneous transluminal coronary angioplasty followed by stent implantation
    • Rotablation
    • Closure of atrial septal defect, patent foramen ovale, and left atrial appendage with occluders
    • Placement of pacemakers and implantable cardioverter-defibrillators
    • Cardiac resynchronization therapy
• Angiology
  • Drug therapy
  • Endovascular procedures (in collaboration with interventional radiologists)
• Endocrinology
  • Drug therapy with oral hypoglycemic medications
  • Insulin therapy, including insulin pumps
  • Diet therapy
• Other medical services