The Unit is highly specialised in the diagnosis and treatment of all cardiac arrhythmias.
The staff of the Arrhythmia Unit consists of 13 cardiologists, 10 nurses dedicated to the angiography suites, 11 ward nurses and a nursing coordinator, and 2 secretaries.
In 2014, a total of 2,379 procedures were performed, including 994 electrophysiological procedures, 860 cardiac stimulations and 490 external electrical cardioversions.
The Arrhythmia Unit has various 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 Cardiology Centre is highly specialised in the diagnosis and treatment of all cardiac arrhythmias and is distinguished for some particular activities:
- 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)
In the setting of the Arrhythmia Unit, 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). Patients requiring an assessment for implantation of a pacemaker also attend the Arrhythmia Unit because of the possibility of performing complete telemetric monitoring of 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 pacemaker 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, the patient undergoes, if deemed necessary, an electrophysiological study to obtain precise indications on the type of pacemaker and the stimulation mode best suited to his or her clinical characteristics. The same diagnostic procedure is also used for those patients with ventricular tachyarrhythmias who, given the severity of their clinical situation and the context of their disorder, require implantation of a cardioverter defibrillator.
The scientific activity of the Electrophysiology Area of the Monzino is aimed at identifying the biochemical and structural predictors of atrial fibrillation and the procedures associated with the improvement of success rates in trans-catheter ablation, especially in patients with persistent AF
The staff is particularly involved in the following research lines:
- transcatheter ablation in atrial fibrillation (AF) and in life-threatening ventricular arrhythmias;
- mapping and endomyocardial diagnostic biopsy in different cardiomyopathies;
- identification of the best left ventricular stimulation strategies in patients with dual-chamber pacemakers and/or implantable cardiostimulants;
- innovative catheters for ablation in ventricular tachycardias; new pacing technologies for a new standard of care.