Department of Arryhythmias and Cardiac Pacing

Prof. MUDr. Robert Hatala, CSc., Consultant of the Department of Arrhythmias and Cardiac Pacing
MUDr. Viera Illíková, Head nurse of the Department of Arrhythmias and Cardiac Pacing

The Department of Arrhythmias and Clinical Electrophysiology (DACP) was created in 1995 as a reaction to the rapidly expanding possibilities to treat arrhythmias in the 90's. It is the only highly specialized tertiary center for comprehensive management of patients with arrhythmias. It has all facilities for complex diagnostics and therapy, including the curative options. This comprehensive approach is reflected in the structure of the department, which comprises:

• patient ward with 16 monitored beds
• 2 cath-labs for invasive and interventional electrophysiology and for implantation of devices (pacemakers and implantable defibrillators), respectively
• 3 specialized outpatient clinics for arrhythmia patients.

DACP is in spite of its young age one of the most dynamic departments of the institute. Almost 900 patients are admitted yearly with a short admission time, not exceeding 5 days, and further almost 6,000 patients are managed on an out-patient basis. The program of invasive electrophysiology comprises mainly:

• radiofrequency catheter ablations (300 / year)
• invasive electrophysiological studies (approximately 300 / year)
• implantation of pacemakers (400/ year, 25% physiological pacing mode)
• implantation of defibrillators (ICD) a comprehensive long-term follow up of ICD patients (up to 40/ year).

The above mentioned procedure numbers qualify the Department as high-volume center on the international scale. The performed procedures have a high success rate and low occurrence of complication, generally below the European mean values.

The physicians of DACP are also involved as consultants in management of patients in other departments within the Institute - besides the Department of Cardiology mainly in the perioperative management of patients undergoing cardiac surgery and in the heart transplantation program. They are also substantially involved in performing non-invasive diagnostic tests such as Holter ECG monitoring, tilt-table testing, body surface potential mapping etc.

The medical staff comprises 9 board certified physicians specialized in arhythmology. Several have passed an extensive post-graduate training abroad and have relevant clinical experience from leading arrhythmia centers in countries in North America and Western Europe (Canada, Germany, Belgium, France, Austria etc.). All physicians are equipped with active working knowledge of several languages. This allows for continuous intensive links with centers abroad. This is crucial not only for maintaining permanent contact with the latest clinical research but also allows for state-of-the-art management of patients, if necessary in direct collaboration with these centers. High quality nursing care is ensured by 42 registered nurses and other allied professionals.

The technical equipment has recently been substantially upgraded thanks to a successfully realized PHARE project of the European Union. Thanks to this investment our center is as one of the first in Central Europe equipped with a high-speed electrophysiology 64-channel signal acquisition system together with a system for non-fluoroscopic electro-anatomical mapping by means of intracardiac magnetic navigation.

Staff physicians and nurses are active also in clinical research. They publish in foreign and domestic journals. During the last 5 years over 100 papers were presented on international and national congresses, young colleagues have been repeatedly awarded the "Young investigators award" of the Slovak Society of Cardiology. The director of the department is also in the position of associate professor affiliated to the Slovak Medical University and the Comenius University School of Medicine in Bratislava. Three physicians are currently in the postgraduate PhD program.

DACP has been participating in several important multi-center clinical trials with possible important impact on clinical practice in the future. It also cooperates with the institutions involved in basic medical research (Slovak Academy of Sciences, Comenius University School of Medicine). The department is accredited for postgraduate training in arhythmology by the European Society of Cardiology, and has a decisive role in postgraduate training of arhythmologists for other Slovak centers for cardiac pacing.