Sick sinus syndrome (SSS) diagnosis in Hospital Oberberg Waldbrol

About the department

The Department of Cardiology at the Hospital Oberberg Waldbrol provides the full range of diagnostic and therapeutic services to patients with cardiovascular diseases. The department conducts conservative therapy and performs minimally invasive interventions using catheter-based techniques. The medical facility has an advanced Cardiac Catheterization Laboratory specializing in interventional treatment, in which more than 3,000 cardiac examinations and many therapeutic procedures are performed every year. This laboratory is the only one of this kind in the Oberbergischer district. The department is distinguished by its successful experience in the treatment of heart arrhythmias through the implantation of pacemakers and defibrillators. The department's cardiologists also treat coronary artery stenoses and occlusions using transluminal coronary angioplasty, followed by stent implantation, and perform interventional procedures to close atrial septal defects and patent foramen ovale. Since November 2021, the department has been certified as a Chest Pain Unit, so patients with acute coronary syndrome can count on high-quality treatment in accordance with European medical standards. Since 1997, the department has offered outpatient cardiac rehabilitation, which is one of the key elements in achieving excellent long-term treatment outcomes. The department is headed by PD Dr. med. Vedat Tiyerili.

The key focus of the department's cardiologists is the performance of interventional heart examinations and therapeutic interventions for heart disease. These procedures are performed in a specially equipped Cardiac Catheterization Laboratory. The specialists perform more than 3,000 catheter-based procedures annually, which testifies to the vast experience of the department's doctors in this medical field. 

Coronary artery disease (CAD) is one of the most common heart pathologies, increasingly diagnosed in young patients. Without timely treatment, coronary artery disease may provoke myocardial infarction or even lead to death. The most effective method of assessing the degree of coronary stenosis in patients with CAD is imaging the coronary arteries using coronary angiography. The department has a modern cardiac catheterization system that uses special detectors instead of conventional X-ray intensifiers. Imaging of the beating heart provides the most accurate image of the blood vessels of all diameters, down to the smallest arterioles. Thanks to this, doctors can simultaneously perform a diagnostic intervention and follow-up treatment, namely transluminal coronary angioplasty followed by stent implantation.

Coronary angioplasty involves introducing a balloon catheter of specially selected length and diameter into the lumen of the blood vessel narrowed by an atherosclerotic plaque through a puncture in the femoral artery. Following image-guided positioning of the balloon in the required area, the doctor inflates it, thereby expanding the lumen of the narrowed coronary artery and normalizing the blood supply to the heart. As a rule, after the elimination of coronary occlusion, a stent (a thin, hollow metal tube) is placed in the blood vessel to prevent recurrent stenosis. As a low-traumatic procedure, transluminal coronary angioplasty is performed under local anesthesia and allows for excellent results. The use of modern stents made from improved materials and drug-eluting stents helps to significantly reduce the risk of developing repeated stenosis. The department's cardiologists use state-of-the-art systems for vascular approaches (for example, AngioSeal), so the period of bed rest after the intervention is significantly reduced, and patients can already get on their feet in 2-4 hours after the operation.

It is worth noting that coronary angioplasty and stent implantation techniques are also effective for the treatment of acute myocardial infarction. Patients with this diagnosis are admitted to the department around the clock. After emergency treatment, doctors transfer the patient to the Intensive Care Unit for them to stay under the constant monitoring of medical staff.

The department's specialists also excel in the treatment of heart arrhythmias. The diagnosis of heart rhythm disorders is mainly performed with the help of an ECG, including 24-hour ECG monitoring. In the initial stages of heart arrhythmias, patients are treated with drugs, but in advanced cases, more radical treatment may be required. The department performs more than 200 pacemaker implantation procedures annually. Biventricular pacemakers with three electrodes (including the resynchronization electrode) are used to treat heart failure. The department also implants defibrillators for the treatment of heart arrhythmias. Interventional procedures of this kind are performed using catheter-based techniques under local anesthesia and under imaging guidance. The department's specialists are also responsible for postoperative adjustment of the implanted artificial pacemakers and regular heart examinations of patients who have undergone pacemaker or cardioverter-defibrillator implantation.

The department's therapeutic offer is complemented by catheter-based interventions to close atrial septal defects and patent foramen ovale with an occluder. Occluder placement procedures are performed under local anesthesia with the use of imaging systems. Thanks to a percutaneous approach and minimal trauma to healthy tissues when approaching the pathological focus, patients tolerate occluder placement interventions well, with complications and health risks being close to zero.

The department's range of diagnostic and therapeutic services includes:

• Diagnostic procedures
  • Echocardiography, including transesophageal echocardiography, transthoracic echocardiography, and stress echocardiography
  • Electrocardiography
  • 24-hour ECG monitoring
  • 24-hour blood pressure monitoring
  • Ergometry
  • Spiroergometry
  • Coronary angiography
  • Intracoronary ultrasound imaging
• Catheter-based interventional procedures
  • Transluminal coronary angioplasty followed by stent implantation, including implantation of drug-eluting stents
  • Catheter-based interventional procedures for the closure of atrial septal defects
  • Catheter-based interventional procedures for the closure of a patent foramen ovale
  • Implantation of pacemakers (VVI and DDD pacemakers)
  • Implantation of biventricular pacemakers for cardiac resynchronization therapy
  • External electrical cardioversion
• Other diagnostic and treatment methods