Royalhealth Heart Center

Our cardiovascular service diagnoses and treat conditions affecting organs inside the chest (the thorax), mainly the lungs and heart, and the major blood vessels that affect circulation.

Non-invasive cardiology

We’re one of the unique diagnostic units in the Al Ain, with some of the most advanced equipment. This allows our specialists to evaluate the condition of your heart and diagnose any problems.
Our team also looks after people who have been fitted with devices, such as pacemakers and implantable cardioverter defibrillators (ICDs).
The services we provide are:

Diagnostic monitoring

We use portable devices, which monitor heart’s rhythm and blood pressure during your normal daily routine, to help diagnose potential heart conditions.
The type of device we choose to use will depend on the symptoms and the reason for the monitoring.

    • Heart monitors
A heart monitor may be used to assess the heart rate and rhythm for 24 hours or longer. It can be used to identify abnormal heart rates or rhythms, which may or may not be associated with particular symptoms.
    • Blood pressure monitors
A blood pressure monitor is used to measure and record blood pressure over a 24-hour period during your normal daily routine. It can be used to diagnose conditions such as high blood pressure (hypertension).
    • Cardiac event recorders
A cardiac event recorder is a small hand-held device which is used to record the heart rate and rhythm when we activate it. The recordings are then sent through to the department using the event recorder and a landline telephone. This can help the doctor to see if any symptoms patient might be experiencing are associated with changes in the heart rate and rhythm.

Diagnostic tests

We can use a variety of tests to assess how your heart responds in different situations. These tests may be used to diagnose new conditions or assess existing ones.

    • Electrocardiogram (ECG)
An ECG records the rhythm and electrical activity of the heart.
Small patches called electrodes are placed on the arms, legs and chest. These are connected to a recording machine which picks up the electrical signals produced by each heartbeat.
The test can show problems with your heart rhythm, but you are likely to have other tests as well as an ECG.
    • Exercise stress test
An exercise stress test aims to assess the tolerance and response to exercise. This test is also referred to as an ‘exercise tolerance test’ or just an ‘exercise test’.
    • Cardio pulmonary exercise test
A cardio pulmonary exercise test is used to assess the response of the heart and lungs to exercise. The test is useful for a number of cardiac and respiratory conditions.

Device follow-up

Patients may need to have a device implanted, such as a pacemaker or implantable cardioverter defibrillator, to help manage an abnormal heart rhythm.
The procedure to implant the device will be carried out in the cardiac catheter labs but the patients we will manage the follow-up care. As part of patient’s routine follow-up appointment, we will automatically download information from the device and get the full report.

    • Pacemaker
A pacemaker fitted if the heart beats too slowly, too irregularly or if at risk of blackouts. Pacemakers stimulate contractions of the heart by sending electrical signals to the heart each time it fails to beat on its own. They are usually fitted to the upper left side of the chest with leads secured into the heart muscle.
    • Implantable cardioverter defibrillator (ICD)
An ICD implanted because patients survived a cardiac arrest considered to be at risk of developing a potentially life-threatening heart rhythm.
The ICD will treat the fast impulses from the heart’s ventricles, by either pacing out the fast rhythm or by delivering shock therapy. Although this is not pleasant it is lifesaving.
    • Implantable loop recorders
Implantable loop recorders are small devices implanted to monitor the heart’s rate and rhythm. They’re typically implanted for around three years. Their purpose is to help diagnose abnormal heart rhythms.

Imaging (ultrasound)

Our team of specialist sonographers will use the latest 2D and 3D echocardiography technology to produce images for the heart.

    • Echocardiogram
An echocardiogram or ‘echo’ is a scan that uses sound waves (ultrasound) to produce pictures of the heart. It’s a completely painless test that doesn’t have any side effects and doesn’t use radioactivity. An echocardiogram tells us how well the heart is pumping and whether the heart valves are working properly, but it doesn’t indicate whether or not to have angina.
    • Stress echocardiogram
A stress echocardiogram or ‘stress echo’ is a test we use frequently to diagnose and assess angina (a pain associated with coronary artery disease). It does this by looking to see whether there is an adequate blood supply to the heart muscle when the heart rate is increased. We also occasionally use stress echocardiograms to assess other conditions such as valvular heart disease.

Cardiac rhythm management

We’re a world-renowned unit helping patients with heart rhythm disorders. We study and treat the electrical conduction and disturbances of the heart, also known as cardiac electrophysiology.
We see patients with a wide range of heart complaints, from people with palpitations and dizzy spells, to patients who have survived an episode of sudden cardiac death.
As a center of excellence for diagnosing and treating heart rhythm disorders, patients from surrounding areas are referred to our specialists. We have particular experience in atrial fibrillation ablation, ablation and device therapies in congenital heart disease, and cardiac resynchronization therapy for heart failure patients.

Rapid access chest pain clinic

Our rapid access chest pain clinic assesses people with suspected angina. Angina is a chest pain that occurs with exercise and resolves with rest and may indicate a partial blockage of a coronary artery.

Vascular services

Invasive cardiology

  • Cardiac Catheterization
Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization.
Cardiac catheterization is done to see if there is a heart problem, or as a part of a procedure to correct a heart problem that the doctor already knows about.

  • Locate narrowing or blockages in your blood vessels that could cause chest pain (angiogram)
  • Measure pressure and oxygen levels in different parts of your heart (hemodynamic assessment)
  • Check the pumping function of your heart (right or left ventriculogram)
  • Take a sample of tissue from your heart (biopsy)
  • Diagnose heart defects present from birth (congenital heart defects)
  • Look for problems with your heart valves

Cardiac catheterization is also used as part of some procedures to treat heart disease. These procedures include:
Angioplasty with or without stent placement. Angioplasty involves temporarily inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery.
Angioplasty is usually combined with implantation of a small metal coil called a stent in the clogged artery to help prop it open and decrease the chance of it narrowing again (restenosis).

  • Electrophysiology Procedure
Heart arrhythmia treatment (ablation). Ablation is a procedure used to treat heart rhythm problems. Radiofrequency energy (heat), a laser or nitrous oxide (extreme cold) can be applied to abnormal heart tissue through the tip of a catheter. This is done to reroute electrical signals or destroy (ablate) areas that are causing the heart rhythm disorder.
  • Cardiac Device Implantation
Sometimes lifestyle change and medication aren’t enough to combat heart disease. When other treatments are no longer effective, physician may recommend an implantable cardiac device (pacemaker) to help monitor and/or regulate the rhythm of the heart. There are different types of implantable devices, and it depends on the diagnosis as to which type the doctor will choose for. Cardiac resynchronization therapy (CRT) pacemakers help a very slow heart beat more regularly. Implantable cardioverter defibrillators (ICDs) shock the heart when it is beating too fast to prevent cardiac arrest. Additionally, some devices have been developed that can do both.

Pacemaker

A pacemaker literally sets the pace of the heart. This tiny device is implanted under skin and attached to the heart by tiny wires or leads. The signals, or pacing pulses, are carried along this electrical lead, to the heart and stimulate the heart muscle to beat. It monitors and adjusts the heartbeat based on customized limits. If the heart rate is slower than the set low limit, an electrode sends an electrical current to the heart causing it to beat. If the heart rate is faster than the set high limit, no current is sent.

Implantable Cardioverter Defibrillator (ICD)

ICDs are small devices that are surgically implanted just below the collarbone. It connects to the heart using tiny wires, or leads, and continuously monitors the heart’s rhythm. When the heart beats to quickly, the ICD delivers a life-saving electrical current to restore the hearts normal rhythm and prevent sudden cardiac death. ICDs can also act as a pacemaker, when a slow heart rate is detected. ICDs monitor and adjust the heartbeat based on customized, high and low limits, and are similar to a pacemaker.

Cardiac Resynchronization Therapy (CRT) for Heart Failure (Bi-Vent Pacing) or (Bi-Vent ICD)

CRT is innovative new therapy for patients with heart failure by improving the coordination of the heart’s contraction. CRT builds on the technology used in pacemakers and ICDs. It also can protect the patient from slow or fast heart rhythms. The CRT device has three electrical leads that are placed in the right and left chambers of the heart – different from a pacemaker or ICD which only have electrical leads placed in the right side of the heart. This allows the CRT device to simultaneously stimulate the left and right sides of the heart and restore the heart’s coordinated pumping function. This is referred to as Bi-ventricular pacing.

Cardiac Rehabilitation

Cardiac rehabilitation refers to a structured program of exercise and education designed to help you return to optimal fitness and function following an event like a heart attack. It’s usually provided by a team of specialists in various settings; these healthcare professionals work together to help you improve your functional mobility, decrease risk factors related to your cardiac injury, and help you and your family manage the psychosocial effects that may influence your recovery after a heart attack.

There are four phases of cardiac rehabilitation. The first phase occurs in the hospital after your cardiac event, and the other three phases occur in a cardiac rehab center or at home, once you’ve left the hospital. Keep in mind that the recovery after a cardiac event is variable; some people sail through each stage, while others may have a tough time getting back to normal. Work closely with your doctor to understand your progress and prognosis after a cardiac event.

Phase One Cardiac Rehab: The Acute Phase

The initial phase of cardiac rehabilitation occurs soon after your cardiac event. An acute care physical therapist will work closely with your doctors, nurses, and other rehabilitation professionals to help you start to regain your mobility.
If you’ve had a severe cardiac injury or surgery, such as open heart surgery, your physical therapist may start working with you in the intensive care unit (ICU). Once you no longer require the intensive monitoring and care of the ICU, you may be moved to a cardiac stepdown unit.
The initial goals of phase one cardiac rehabilitation include:

  • Assess your mobility and the effects that basic functional mobility has on your cardiovascular system
  • Work with doctors, nurses and other therapists to ensure that appropriate discharge planning occurs
  • Prescribe safe exercises to help you improve your mobility, and to improve cardiac fitness.
  • Help you maintain your sternal precautions is you have had open heart surgery.
  • Address any risk factors that may lead to cardiac events
  • Prescribe an appropriate assistive device, like a cane or a walker, to ensure that you are able to move around safely
  • Work with you and your family to provide education about your condition and the expected benefits and risks associated with a cardiac rehabilitation program

Phase Two Cardiac Rehab: The Subacute Phase

Once you leave the hospital, your cardiac rehabilitation program will continue at an outpatient facility. Phase two of cardiac rehabilitation usually lasts from three to six weeks and involves continued monitoring of your cardiac responses to exercise and activity.
Another important aspect of phase two cardiac rehabilitation is education about proper exercise procedures, and about how to self-monitor heart rate and exertion levels during exercise. This phase centers around your safe return to functional mobility while monitoring your heart rate.
Towards the end of phase two, you should be ready to begin more independent exercise and activity.

Phase Three: Intensive Outpatient Therapy

Phase three of cardiac rehabilitation involves more independent and group exercise. You should be able to monitor your own heart rate, your symptomatic response to exercise, and your rating of perceived exertion (RPE). Your physical therapist will be present during this phase to help you increase your exercise tolerance, and to monitor any negative changes that may occur during this phase of cardiac rehab.
As you become more and more independent during phase three of cardiac rehabilitation, your physical therapist can help tailor a program of exercises, including flexibility, strengthening, and aerobic exercise.

Phase Four: Independent Ongoing Conditioning

The final phase of cardiac rehabilitation is your own independent and ongoing conditioning. If you have participated fully in the previous three phases, then you should have excellent knowledge about your specific condition, risk factors, and strategies to maintain optimal health.
Independent exercise and conditioning is essential to maintaining optimal health and preventing possible future cardiac problems. While phase four is an independent maintenance phase, your physical therapist is available to help make changes to your current exercise routine to help you achieve physical fitness and wellness.

info@royalhealth.ae
02444 6063
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