Hemodynamics

The Hemodynamics lab is mainly concerned with diagnostic coronary angiography and with treatment through coronary angioplasty coupled with stenting of the ischemic heart disease across its various clinical manifestations: stable angina pectoris, unstable angina pectoris and acute myocardial infarction.

Part of its prerogative is also the invasive diagnostics of valvular heart diseases, myocardiopathies and heart failure, by resorting to right heart catheterization and ventriculography.

We also carry out the percutaneous closure of the patent foramen ovale (PFO) and the septal defect.

Electrophisiology and Cardiostimulation

The Electrophysiology and Cardiostimulation Lab carries out routine operations to install and replace pace makers, implantable cardiac defibrillators (ICD), with biventricular function as well, with a view to treating heart failure through cardiac resynchronization therapy defibrillator (CRT-D), implantable Loop Recorder (long-term ECG monitoring systems), electrophysiological studies and transcatheter ablations for the most common arrhythmias.

All the examinations are carried out while admitted to hospital.

Zero rays: non-fluoroscopic mapping in arrhythmias

The Transcatheter ablation through Radiofrequency is a treatment which is indicated for many arrhythmias; the procedure, carried out under fluoroscopic guidance, exposes the patient, as well as the operators to a not always negligible amount of radiations.

 

The existing relationship between exposure to radiations and the risk of developing cancer or genetic anomalies is the most important reason which prompts the Electrophysiology labs to research a possible reduction of the exposure times to radiations.

One might think, among other things, of the fact that many patients with arrhythmias are of paediatric age or in any event quite young, and are often of female sex, that is, the most vulnerable patients to the effects of radiations.

The use of three-dimensional non-fluoroscopic mapping systems has made it possible to smash these exposure times in the longer and more complex procedures (such as the ablation of Atrial Fibrillation).

Apart from reducing the exposure times, these systems are a valid tool as diagnostic aids.

The increasingly more widespread interest in workplace safety, coupled with the patient’s growing sensitivity to and information about these issues, has ensured that the use of non-fluoroscopic mapping systems is requested throughout the procedures.

Since 2014, in our Electrophysiology lab we have been using the NavX system (non-fluoroscopic mapping with 3D reconstruction of the heart chambers) in respect of the ablation of all the arrhythmias, from the simplest to the most complex ones, with a view to significantly smashing the use of fluoroscopy.

The results of the first procedures undertaken, albeit as part of a Learning Curve, point to a drastic reduction in exposure to fluoroscopies, which has moved from an average 5810 DAP to 247 DAP (8 standard cases v. 8 No Fluoroscopy cases).

Examples of treatment

Subcutaneous Implantable Cardiac Defibrillators:
Watch the video of the operation carried out by Dr. Giulio Molon from our Service.

Percutaneous closure of the Left Atrial Appendage by resorting to Watchman prosthesis in an elderly person suffering from Atrial Fibrillation (AF), and anaemia caused by recurrent gastrointestinal bleeding.
Watch the video of the operation carried out by Dr. Giulio Molon from our Service.
Watch the presentation video of the operation (on the occasion of the international ictus day) on RAI Uno Mattina of 29 October 2013 and on TG5 of 7 November 2013.