Cesar Unit: Innovative Cardiology Care & Research in Paris

Parisian cardiology is seeing a new model of care emerge, one designed to bridge gaps in access and accelerate research. Called Cesar – an ambulatory cardiology emergency unit – the initiative, launched in May 2025, is already demonstrating a high return on investment and strong patient satisfaction, with an average score of 94/100. The unit, a collaboration between the Lariboisière and Saint-Louis hospitals (AP-HP), aims to provide timely cardiac care while simultaneously serving as a rich source of data for ongoing research.

Addressing Access Challenges and Rising Acuity

The impetus for Cesar stemmed from difficulties patients faced in obtaining timely appointments with cardiologists in the Paris region. Dr. Théo Pezel explains that Cesar functions as a city-facing emergency cardiology unit, operating Monday through Friday. Currently, the unit evaluates between 10 and 15 patients daily, referred by emergency departments at Lariboisière and Saint-Louis hospitals, and a network of approximately ten general practitioners. Direct self-referral is not permitted; all patients must come through the established referral system. A key component of the unit’s structure is the presence of a senior cardiologist at all times, supported by a team including nurses, a secretary, a health care manager, a nursing assistant, a cardiology intern, and two externs.

Interestingly, the complexity of cases seen at Cesar has increased significantly since its inception. In May 2025, only about 10% of patients presented with a major cardiac issue. Now, that figure has risen to 50%. This shift underscores the growing need for accessible, specialized cardiac care. The unit anticipates a gradual increase in patient volume, aiming to treat 15 patients per day in 2026 and 20 in 2027, while maintaining a high standard of care. To support this expansion, a dedicated cardiac scanner is slated for installation by the end of 2026, enabling faster and more comprehensive patient evaluations.

A Hub for Innovation and Data-Driven Research

Cesar is not simply a clinical unit; it’s conceived as a “data warehouse” for health research, leveraging the expertise of Pr Éric Vicaut, a methodologist involved with the unit. Patients are invited to participate in an observational study, providing informed consent for the collection of clinical, biological, genetic data, as well as results from echocardiograms, and scans. This data-centric approach allows researchers to address a range of questions and advance understanding of cardiovascular disease.

The unit is actively forging partnerships with start-ups to explore innovative technologies. One example is e-Sensia, which utilizes artificial intelligence to analyze patient voice patterns to predict the risk of heart attack or stroke. Milan Lazarevic and Quentin Demanet, directors of clinical research and innovation (DRCI) at the AP-HP, envision Cesar as a central hub for both academic and industrial innovation. Physight, the first spin-off company from the AP-HP, is already incubated within Cesar’s research team. Physight has developed “Laurier,” an AI-powered software designed to improve care and transform clinical research within the unit. Cesar also prioritizes medical education, providing training opportunities for interns, externs, and continuing education for healthcare professionals.

Balancing Emergency Care with Ambulatory Focus

While equipped to handle a range of cardiac issues – including ECGs, advanced blood pressure monitoring, and access to cardiac MRI and CT scans – Cesar maintains a strong focus on ambulatory care. Notably, only 6% of patients seen at Cesar require hospitalization, despite the fact that 50% present with severe conditions. This highlights the unit’s success in delivering effective care and treatment in a safe environment, allowing patients to return to their primary care physicians. The unit’s equipment includes two waiting rooms, a treatment room with two beds, a dedicated workspace for nurses and paramedics, and specialized machines for ECGs and echocardiography. The addition of the dedicated cardiac scanner in late 2026 will further enhance diagnostic capabilities, allowing for approximately 40 additional examinations per day.

Expanding Access Through SAMU Integration

Looking ahead, Professor Anthony Chauvin, head of the emergency department at Lariboisière, hopes to integrate Cesar with the local SAMU (emergency medical services) dispatch system by June 2026. This would allow SAMU teams to directly refer patients to Cesar, potentially streamlining care and reducing wait times for critical cardiac evaluations. This integration would further solidify Cesar’s role as a key component of the Parisian cardiology network.

The Role of Cardiac Computed Tomography

Dr. Théo Pezel is also involved in research related to cardiac computed tomography (CT), as evidenced by his contributions to sessions at the European Association of Cardiovascular Imaging (EACVI). His ESC 365 profile details presentations on topics ranging from coronary artery disease to valvular heart disease imaging, and the application of photon-counting CT technology. This expertise will likely inform the use of the new dedicated cardiac scanner at Cesar, ensuring patients benefit from the latest advancements in cardiac imaging. He also presented function at the European Society of Cardiology (ESC) congress in 2023, proposing a machine-learning score using cardiac MRI to predict outcomes in acute myocarditis. Details of this research were shared on LinkedIn.

Cesar represents a promising model for delivering accessible, high-quality cardiac care while simultaneously driving innovation and advancing medical knowledge. The unit’s success hinges on its collaborative approach, its commitment to data-driven research, and its dedication to providing a positive patient experience.