Department of Electrophysiology & Cardiac Pacing


Quick Facts

The Unit is highly specialized in the diagnosis and treatment of any heart rhythm disorder.
The medical staff consists of: 13 doctors cardiologists, 10 nurses dedicated to the angiographic rooms, 11 nurses and 1 nurse coordinator dedicated to inpatient care and 2 secretarial employees.

The Arrhythmia Unit has different areas of activity, in particular:

  • remote monitoring of implanted pacemakers and defibrillators (home monitoring)
  • the study and treatment of atrial fibrillation
  • clinical electrophysiology
  • cardiac stimulation.

The Arrhythmia Unit of Monzino is highly specialised in the diagnosis and treatment of all cardiac arrhythmias. The main activities are:

  • Electrophysiological evaluation and ablation assessment of patients with atrial fibrillation
  • Transcatheter mapping and ablation in patients with episodes of ventricular tachycardia
  • Endomyocardial biopsy for the diagnosis (genetic, viral and histological) of myocardial diseases responsible for rhythm disorders
  • Study of the correlation between rhythm disorders and neurodystrophic diseases
  • Implantation of biventricular devices for patients with various forms of heart failure
  • Antiarrhythmic heart surgery
  • Implantation of electrode-free pacemakers (leadless pacemakers)

Cardiac stimulation

The cardiac stimulation service offers an extremely broad range of implanted solutions, ranging from the simplest placement of a single-chamber pacemaker to the use of more sophisticated and cutting-edge stimulation systems exploiting the most advanced technology (biventricular devices and defibrillators).
In this Unit the patients that require an assessment for a stimulation device implantation can benefit from a complete telemetric monitoring with a 12-lead electrocardiogram.

The cardiac stimulation service is operative 24 hours a day with round-the-clock availability of the medical and paramedical staff employed in the facility.
This enables quick decisions on whether a patient needs implantation of a permanent stimulation device and to proceed accordingly.

In non-acute conditions, the patient is admitted to the Arrhythmia Ward for a series of tests before the definitive indication for pacemaker implantation.

In addition to non-invasive evaluations, if deemed necessary, the patient undergoes an electrophysiological study to obtain precise indications on the type of device best suited to his or her clinical characteristics.
The same diagnostic procedure is also used for those patients with ventricular tachyarrhythmias who require the implantation of a cardioverter defibrillator.

Research Activities

  • In addition to the intense clinical activity, the entire Department is intensively engaged in clinical and experimental research.
    There are different areas of scientific interest:

    • study of the pathophysiology of atrial fibrillation in different clinical manifestations and in different clinical contexts (valvular pathology, heart failure, hypertrophic cardiomyopathy);
    • etiopathogenetic research of cardiomyopathies, by means of an electroanatomical mapping study associated with endomyocardial biopsy for genetic, genomic and histological analysis of the analysed tissue;
    • genetic-functional correlations of neuropathies and muscular dystrophy with pathologies of heart rhythm and electrical impulse conduction;
    • evaluation of the arrhythmic substrate in the different forms of cardiopathy, by a combined endo-epicardial electroanatomical mapping study;
    • evaluation of different forms of alternative ablative energy (laser energy, cryoenergy,...) for the ablation of atrial fibrillation in both experimental (animal studies) and clinical settings;
    • study in collaboration with cardiosurgery for the ablation of idiopathic atrial fibrillation by thoracoscopy;
    • clinical evaluation of 3-dimensional intracavity navigation systems without the aid of radioscopy;
    • clinical evaluation of a robotic magnetic navigation system for the mapping and transcatheter ablation procedures of atrial and ventricular arrhythmias.
    • functional evaluation of contractile dysergia and hemodynamic correlations by non-contact mapping of the electrical activation of the left ventricle to guide re-synchronization therapy.