Implantation of cardioverter- defibrillator in patients with cardiac insufficiency in University Hospital Greifswald

About the department

The Department of Cardiology, Angiology and Pulmonology at the University Hospital Greifswald offers all the options of modern medicine in the areas of its specialization. Patients can undergo comprehensive diagnostics and effective treatment for heart, blood vessel, and lung diseases here. Of particular interest is the treatment of coronary heart disease, acute and chronic heart failure, arterial hypertension, and cardiac arrhythmias. The department has 2 state-of-the-art Cardiac Catheterization Laboratories, where doctors perform balloon dilatation, vascular stent implantation, laser angioplasty, heart valve repair and replacement, and other advanced interventions. The team of pulmonologists in the department cooperates closely with thoracic surgeons. The doctors most commonly treat chronic obstructive pulmonary disease, interstitial lung disease, lung tumors, and pulmonary hypertension. The treatment is based on drug therapy and endoscopic interventional procedures. The department also successfully performs extracorporeal membrane oxygenation (ECMO) for severe forms of acute respiratory failure. The department has 108 beds. The Head Physician of the department is Prof. Dr. med. Marcus Dörr.

The department's primary clinical focus is on medical care for patients with heart disease. The department has at its command excellent infrastructure available for patient care: modern diagnostic rooms, specialized outpatient clinics, and advanced Cardiac Catheterization Laboratories. The team of the department's cardiologists is convinced that the key to successful treatment is high-precision preliminary diagnostics, and therefore doctors have a perfect command of various non-invasive and invasive diagnostic procedures. The diagnostic process usually begins with the following non-invasive examinations: echocardiography, including transthoracic, transesophageal, stress echocardiography, and 3D/4D echocardiography; resting ECG and long-term ECG monitoring; 24-hour blood pressure monitoring; ultrasound scans of the blood vessels of the brain, lower limb arteries, kidney arteries, and the abdominal aorta. In some cases, a patient may also require invasive diagnostic procedures, including classical coronary angiography and 3D rotational angiography, fractional flow reserve measurement, intravascular ultrasound scans, right and left heart catheterization, pericardial puncture, and myocardial biopsy. The department's patients are thus offered all the diagnostic options available in modern cardiology. Based on the results of cardiac diagnostic testing, an accurate diagnosis is made and an optimal treatment regimen is prescribed.

Treatment for heart disease is also at the highest level. Whenever possible, doctors use only an effective course of drug therapy. In more complex clinical cases, the specialists perform interventional procedures in the Cardiac Catheterization Laboratory. The most demanded therapeutic interventions include percutaneous stent implantation for coronary heart disease, rotablation, transcatheter aortic valve implantation (TAVI), implantation of the MitraClip and Carillion systems for mitral valve insufficiency, percutaneous closure of the patent foramen ovale, and percutaneous closure of the atrial appendage.

The department offers special options for treating heart arrhythmias (heart rhythm disturbances). Successful interventions to implant single, double, and triple chamber pacemakers and defibrillators to normalize the heart rhythm are performed here. The department's cardiologists use in their work reliable devices from such world-famous manufacturers as Medtronic, Biotronik, Boston Scientific, Abbott, and others. Modern types of ablation are also carried out here. Vast experience in the field of pacemaker implantation, combined with advanced technical imaging equipment, allows the specialists of the medical facility to achieve excellent treatment outcomes.

Angiology has also been one of the department's key areas of specialization for many years. In this medical field, doctors diagnose and treat the full range of diseases of the arteries, veins, and lymphatic vessels. Angiologists work closely with physicians from other specialties, including internists, dermatovenereologists, surgeons, diabetologists, nephrologists, radiologists, and neuroradiologists. The doctors regularly meet at a board meeting to discuss clinical cases and develop the most effective treatment regimens. The department's specialists focus on patients with occlusive peripheral arterial disease, abdominal and retroperitoneal artery occlusions, diabetic foot syndrome, renal artery stenosis, abdominal aortic aneurysms, venous thrombosis, pulmonary embolism, phlebothrombosis, thrombophlebitis, and other pathologies. In many cases, doctors manage to carry out drug therapy for vascular pathology. However, patients with complex vascular lesions often require interventional therapeutic procedures such as drug-eluting balloon angioplasty, stent implantation, catheter-based atherectomy, lysis therapy, etc.

Pulmonology is another important area of clinical activity for the department's doctors. The team of pulmonologists treats patients with obstructive airway disease, interstitial lung disease, lung tumors, pulmonary hypertension, and lung infections. The department's therapeutic options include drug therapy, mechanical ventilation, and bronchoscopic procedures. There is also a specialized center in the department that performs extracorporeal membrane oxygenation (ECMO). This type of treatment is indicated for patients with severe acute respiratory failure and is available only in advanced medical facilities.

The department's range of medical services includes the following options:

• Cardiology
  • Diagnostic services
    • Non-invasive cardiac tests
      • Transthoracic and transesophageal echocardiography including 3D/4D echocardiography, contrast-enhanced echocardiography, and stress echocardiography
      • Resting and long-term ECG monitoring
      • 24-hour blood pressure monitoring
      • Ergometry and spiroergometry
      • Spirometry, body plethysmography, and lung diffusion capacity measurement
      • Ultrasound scans: duplex sonography of the blood vessels of the brain, lower limb arteries, kidney arteries, and abdominal arteries
      • Non-invasive electrophysiological studies: an event recorder, a passive orthostatic test (a tilt table test) and an ajmaline provocation test for suspected Brugada syndrome
    • Invasive cardiac tests
      • Coronary angiography, including 3D rotational angiography
      • Fractional flow reserve measurement
      • Intracoronary tomography with intravascular ultrasound and optical coherence tomography
      • Right heart catheterization at rest and during exercise with invasive pressure measurement in the pulmonary circulation
      • Pericardial puncture (diagnostic and therapeutic)
      • Myocardial biopsy for the differential diagnostics of heart failure
      • Invasive electrophysiological studies: 3D mapping with the CARTO® system and intravascular ultrasound
  • Therapeutic services
    • Conservative treatment
      • Drug therapy
    • Interventional treatment
      • Coronary angioplasty (PTCA) and stent implantation for coronary heart disease
      • Reopening of chronic coronary occlusions
      • Treatment of extended stenoses of blood vessels with severe calcification (rotablation)
      • Transcatheter aortic valve implantation (TAVI)
      • Implantation of the MitraClip and Carillion systems for mitral valve insufficiency
      • Closure of a patent foramen ovale/atrial septal defect
      • Implantation of an atrial appendage occluder
      • Implantation of single, double, and triple chamber pacemakers and defibrillators
      • Ablation
• Angiology
  • Diagnostic services
    • Color duplex sonography of the cerebral vessels, limb arteries, renal arteries, and abdominal blood vessels
    • Compression ultrasonography of the veins of the lower limbs
    • Light reflection plethysmography
    • Capillary microscopy
    • Treadmill ergometry
  • Therapeutic services
    • Conservative treatment
      • Drug therapy
    • Interventional treatment
      • Drug-eluting balloon angioplasty
      • Stent implantation
      • Catheter-based atherectomy
      • Lysis therapy
• Pulmonology
  • Diagnostic services
    • Flexible and rigid diagnostic bronchoscopy
    • Transthoracic and endobronchial ultrasound scans
    • Pulmonary function tests
  • Therapeutic services
    • Conservative treatment
      • Drug therapy
    • Interventional treatment
      • Flexible and rigid therapeutic bronchoscopy
      • Artificial lung ventilation
      • Extracorporeal membrane oxygenation (ECMO)
• Other diagnostic and treatment methods in the field of cardiology, angiology, and pulmonology