Technology in cardiology

Clinical technology and cardiology have a synergistic relationship with regard to investigation and intervention. Echocardiography complements clinical cardiology, but does not replace competent history taking and clinical examination. Cardiac catheterisation and angiography still remain the ‘gold standard’ for most complex cardiac conditions. Digital radiology systems allow image manipulation, measurement, instant replay and easy storage with less radiation. Magnetic resonance imaging is the investigation of choice for aortic dissection and certain cardiomyopathies. Conventional intra cardiac contact arrhythmia mapping is adequate for the majority of arrhythmias that can be ablated. 3D mapping systems are useful in abnormal hearts or after surgery. Most percutaneous cardiac intervention can be done using PTCA balloons and stents. Complex lesions occasionally may require other expensive techniques that are generally not needed; such as atherectomy and intravascular ultrasound. Arrhythmia devices (pacemakers and ICDs) need careful follow-up with monitoring and interrogation, as adjustments after implantation may be necessary. Great ca re must be taken with computer-generated interpretation of investigations (e.g. ECG), as reliance on this could potentially be dangerous. Cardiac technology and information management have important associated ethical issues