Electrophysiology & Intervention Arrhythmology Department
General characteristics
Arrhythmology - one of the most complex sections of Clinical Cardiology, due to a variety of arrhythmias, the difficulty of their diagnostics and treatment, as well as the possibility of developing such severe complications as thrombosis, myocardial infarction, stroke, heart failure and others. The sudden arrhythmias often require urgent intervention to restore the normal rhythm of the heart and then maintain it. The most important factor in the effectiveness of treatment of the patients is the timely consultation, diagnostics and treatment.
Cardiac arrhythmias can be independent or be a complication of diseases of the cardiovascular or other organ systems. In 80% of patients with ischemic heart disease the arrhythmias of various character has been registered. Among them about 65% are life threatening. The increase of the incidence of cardiac arrhythmias with age is due to changes that occurred in the myocardium and the cardiac conduction system in the aging process. Myocytes are replaced by fibrous tissue, and so-called "sclerodegenerative" changes are occured.
Arrhythmias may not appears and be clinically silent during long time and the patient may do not know about it up to the moment when it will be revealed by doctors during examination.
The most common symptoms of arrhythmia are following:
- Feeling disruptions in the rhythm of the heart, or vice-versa - tachycardia, or "fluttering" of the heart,
- Extremely fast or slow heartbeat,
- Dizziness,
- Shortness of breath,
- Pain in the chest that has pressing character,
- A sense of "failure" of the earth under the feet,
- Nausea and / or vomiting (especially during the transition to the normal rhythm of the arrhythmia, and vice versa),
- Loss of consciousness.
These various manifestations of arrhythmia not always testify the complexity of the arrhythmias. People with minor arrhythmias may lose consciousness, and those patients who have life-threatening arrhythmias - do not have any complaints. Everything can be very individual! However, it is very dangerous to treat arrhythmias oneself! Arrhythmia should be treated by the doctor, after a special examination and determination of the type of arrhythmia, taking into account its location and genesis.
In the department of electrophysiology and interventional arrhythmology noninvasive and invasive electrophysiological studies of the cardiovascular system, advice on arrhythmology and pacing are used, as well as to medical and interventional, endovascular (angioplasty of the coronary arteries, radiofrequency ablation of arrhythmogenic zones, various methods of pacing, resynchronization therapy) and surgical correction of heart rhythm in accordance with international standards and recommendations are carried out.
The Department is equipped with the most modern equipment including patient's monitoring systems, defibrillators, electrocardiographs, and also with wide array of medical equipment for the invasive electrophysiological diagnostics and interventional treatment of arrhythmias.
The main activities of the department are the treatment of complex cardiac arrhythmias, as well as combined heart disease - coronary heart disease, congenital and acquired (valvular) heart disease, complicated by the development of cardiac arrhythmias.
The department employs 4 doctors arrhythmologists, including two certified invasive electrophysiologists, who provide the whole spectrum of arrhythmology procedures. Every year in the Department get treatment around 2000 patients, 1400 of which are out-patients.
Specialists of the Department actively cooperate with leading clinics in Europe, Russia and USA, particularly with Providence Sacred Heart Medical Center and Children's Hospital and Institute of Cardiology of Debrecen (Hungary), periodically conduct scientific seminars, consultations and jointly intervention procedures.
The Center provides urgent and planned in-patient diagnostics and treatment at the following diseases:
- Various Arrhythmias,
- Cardiomyopathy,
- Syncope,
- Heart failure,
- Ischemic heart disease,
- Hypertension,
- Valvular and congenital heart diseases
- Biplan angiograph Arlis (Siemens), equipped also for electrophysiological studies and performance of such intervention procedure as implantation of the pacemaker and cardioverter – defibrillator. Has also all facilities for resynchronizing therapy and ablation performance,
- Echocardiograph (Philips),
- Electrocardiograph (Shiller),
- Treadmill (Shiller) (GE),
- Holter monitoring System (Shiller),
- Defibrillator (Medtronic 20e),
- Multifunctional monitors,
- intensive care unit with a central oxygen supply and with individual monitoring system
Study and procedures performed on an outpatient base
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Multichannel electrocardiography (ECG), |
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Echocardiography (EchoCG), |
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Holter monitoring, |
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Event monitoring, |
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Study, diagnostics and programming of the stimulator, CVD and devices, synchronizing the work of the heart, |
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Excercise test (Treadmill test), |
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Monitoring of blood pressure, |
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Out-patient and out-going arrhythmology consultations. |
Procedures, implementing at the in-patient conditions
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Mapping, |
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Electrical cardioversion |
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Pharmacological cardioversion |
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Some types of electrophysiological studies |
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Transesophageal echocardiography |
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Implantation of temporary transcutaneous pacemaker. |
Interventional procedures, conducted at the Department of electrophysiology and interventional arrhythmology
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Inplantation of cardiostimulators, cardioverters – defibrillators (CVD), stimulators and cardioverters – defibrillators with heart work synchronization, and diagnostic mini-systems (Implantable Loop Recorder): |
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Electrophysiological studies |
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Radiofrequency ablation of ventricular and supraventricular arrhythmias. Ablation - is the destruction of arrhythmogenic foci. In our center performed all types of ablations. In particular: |
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Selective angiography of the heart (coronarography) angioplasty and stenting |
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Angiography of great and periferic vessels of upper and lower extremities. |
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Education material for specialists
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Education material for Patients
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Catheter ablation in arrhythmia |
- , Adamyan K.G., Tumasyan L.R., Chilingaryan A.L. - Comparative assessment of long term outcome of acute myocardial infarction with/without ST-segment elevation , Eur J Echocardiography Abstracts Supplement (2012) 13 (S1), i123
- , S.Jamalyan, Z.Kartoyan, K.Petrosyan, L.Hayrapetyan - Development of Cardiac Electrophysiology in Armenia , Second International Medical Congress of Armenia, Yerevan, Armenia. 2007
- , Smbat Jamalyan, MD, FESC - Emerging risk stratification in Syncope , The European Journal of cardiovascular medicine. Vol. I, issue II, summer 2010, p 38-48.
- , Adamyan K.G., Tumasyan L.R., Chilingaryan A.L. - GRACE risk score as a predictor of short- and long-term events after acute myocardial infarction , IX Congress of Armenian Cardiologists Association / May, 2013
- , S.V.Jamalyan - I control my heart failure or How can we live with heart failure “(patient guide in Russian)
- , Alexandra Kiss, Edina Nagy-Baló, Gábor Sándorfi, Orsolya Hajas, Diana Tint, István Édes, Zoltán Csanádi - Learning curve in circular multipolar phased radiofrequency ablation of atrial fibrillation , Cardiology Journal (ahead of print). DOI: 10.5603/CJ.a2014.0085
- , - Long-term outcome of patients presenting with acute myocardial infarction , VIII Congress of Armenian Cardiologists Association / May, 2011 / (1st Prize at the Young Scientists’ Competition)
- , Adamyan K.G., Chilingaryan A.L. - Prognostic value of GRACE risk score as a predictor of short- and long-term events in patients with acute coronary syndrome. Review. Medical Science of Armenia , National Academy of the Republic of Armenia;N1-2014;3-11
- , Adamyan K.G., Vardanyan S.I., Astvacatryan T.R., Mkhitaryan V.K. - Prognostic value of markers of endothelial dysfunction in patients with acute coronary syndrome , VIII Congress of Armenian Cardiologists Association / May, 2011
- , Smbat Jamalyan, MD, FESC, Jan A. Staessen, MD, PhD, FAHA, FESC - Right Ventricular Outflow Tract Arrhythmias from single ectopic beats to arrhythmogenic right ventricular cardiomyopathy. , Healthcare bulletin. European cardiovascular disease. Clinical insights and practice. Spring edition 2009; page 12.
- , Aharonyan A., Manukyan V., Hovaguimian H.S. - Surgical treatment of dysrythmias in rheumatic mitral disorders: early postoperative and long-term results , Panarmenian international surgical congress journal 2003.
- , - Translation into Russian ESC pocket guideline: “Angina”and ESC pocket guideline: “Acute heart failure”
- , - Translations into Russian ACC and ESC Guidelines:“Management of patient with Atrial Fibrillation” and “Hypertrophic cardiomyopathy”
- , S.V. Jamalyan - When you receive anticoagulation therapy” (patient guide in Russian and Armenian
- 09.12.2016 - MC Erebouni and MC Erasmus (Holland): New prospects for cooperation in arrhythmology
- 02.05.2015 -
- 03.11.2014 - First conference of Armenian Heart Rhythm Association
- 31.10.2014 -
- 30.10.2014 -
- 09.06.2014 -
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15.07.2020 թ. |
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Medical care and Service |
Price (AMD) |
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Primary consultation with doctor |
10,000 |
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Repeated consultation with doctor |
5,000 |
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Echocardiography |
12,000 |
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Transesophageal echocardiography (TEE) (outpatient) |
20,000 |
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ECG |
1,600 |
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Testing of Pacemaker |
6,000 |
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Holter monitor test |
15,000 |
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Treadmill test / (consultation is included) |
15,000 |
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Wound management |
6,000 |
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Online consultation (based on data provided by a relative of the patient) |
20,000 |
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On-site consultation (to other clinic) |
15,000 |
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Arrhythmology Inpatient Services |
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Implantations- bradyarrhythmias treatment |
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Pacemaker implantation/reimplantation |
Price (AMD) |
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Pacemaker implantation/reimplantation, single-chamber EFFECTA SR, Biotronik |
1,350,000 |
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Pacemaker implantation/reimplantation single-chamber VITATRON SR, Medtronic |
1,450,000 |
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Pacemaker implantation/reimplantation single-chamber SENSIA SR, Medtronic |
1,650,000 |
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Pacemaker implantation/reimplantation single-chamber ADAPTA SR, Medtronic |
1,750,000 |
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Pacemaker implantation/reimplantation, dual-chamber EFFECTA DR, Biotronik |
1,600,000 |
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Pacemaker implantation/reimplantation, dual-chamber VITATRON DR, Medtronic |
1,750,000 |
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Pacemaker implantation/reimplantation dual-chamber SENSIA DR, Medtronic |
1,850,000 |
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Pacemaker implantation/reimplantation, dual-chamber ADAPTA DR, Medtronic |
2,150,000 |
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Implantations-Tachyarrhythmias treatment |
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Implantable cardioverter-defibrillator (ICD) implantations /reimplantations |
Price (AMD) |
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ICD implantation/ reimplantation PROTECTA DR, Medtronic |
5,300,000 |
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ICD implantation/ reimplantation IFORIA 3 DR-T, Biotronic |
3,900,000 |
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ICD implantation/ reimplantation PROTECTA VR, Medtronic |
4,950,000 |
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ICD implantation/ reimplantation IFORIA 3 VR-T, Biotronic |
3,800,000 |
The price of implantation of all other models not listed in the table is determined by a separate agreement |
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Implantations-Tachyarrhythmias treatment |
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Resynchronization of ventricular contraction ICD implantation |
Price (AMD) |
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Resynchronization of ventricular contraction,device implantation/ reimplantation Consulta CRT-P, Medtronic |
4,150,000 |
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Resynchronization of ventricular contraction ICD implantation /reimplantation, Maximo II CRT-D, Medtronic |
5,450,000 |
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Resynchronization of ventricular contraction ICD implantation /reimplantation Maximo II CRT-D, Biotronik |
5,000,000 |
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Resynchronization of ventricular contraction ICD implantation /reimplantation, Consulta CRT-D, Medtronic |
6,150,000 |
The price of implantation of all other models not listed in the table is determined by a separate agreement |
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Bradyarrhythmias treatment, others |
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Pacemaker implantations,others |
Price {AMD) |
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Temporary epicardial pacing implantation |
135,000 |
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Pacemaker lead repositioning, UNCLASSIFIED |
1,300,000 |
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ICD Electrode repositioning |
1,400,000 |
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Left ventricular electrode repositioning |
1,250,000 |
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Atrial electrode repositioning |
1,250,000 |
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Right ventricular electrode repositioning |
1,250,000 |
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Wound revision |
1,250,000 |
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Subcutaneous pocket preparation |
1,250,000 |
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Pacemaker explantations /extractions |
Price (AMD) |
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Pacemaker explantation |
895,000 |
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Cardioverter-Defibrillator Explantation |
895,000 |
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Resynchronization devices explantation for ventricular contraction |
895,000 |
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Resynchronization ICD devices explantation for ventricular contraction |
895,000 |
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Complete electrode extraction |
1,000,000 |
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Incomplete electrode extraction |
1,000,000 |
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Pacemaker electrode implantation |
Price (AMD) |
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Epicardial electrode pacemaker implantation (on-site) |
380,000 |
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Right ventricular electrode lead implantation |
1,150,000 |
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Left ventricular electrode lead implantation |
1,650,000 |
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Atrial Electrode Implantation |
1,150,000 |
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Pacemaker/ICD electrode implantation UNCLASSIFIED |
1,000,000 |
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Ablations |
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Paroxysmal ventricular tachycardia ablation |
1,700,000 |
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Paroxysmal supraventricular tachycardia ablation |
1,300,000 |
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His bundle ablation |
1,300,000 |
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Ablation for Atrial Tachycardia |
1,300,000 |
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Atrial fibrillation ablation |
1,300,000 |
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Reablation |
850,000 |
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Ablation failure |
370,000 |
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Diagnostic Interventions |
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Electrophysiology studies test (EPS) – Diagnostic |
Price (AMD) |
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Electrophysiology studies test – transesophageal |
175,000 |
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Electrophysiology studies test – Intracardiac |
370,000 |
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EPS – epicardial (on-site) |
400,000 |
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Diagnostic (other) |
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Phlebography |
75,000 |
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Diagnostic mini system implantation Reveal DX |
1,500,000 |
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Inpatient treatment |
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Inpatient procedures |
Price (AMD)/ (cost of bed and per day is not included |
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Cardioversion |
55,000 |
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Medication exam |
35,000 |
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Device-mediated EPS |
65,000 |
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Inpatient procedures Other |
30,000 |
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Transesophageal echocardiography (TEE) |
45,000 |
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Transcutaneous pacemaker implantation (temporal) |
95,000 |
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General anesthesia during procedure |
125,000 |
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Transesophageal echocardiography (TEE) with Cardioversion |
80,000 |
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Inpatient treatment/hospitalization |
Price (AMD)/ (cost of bed and per day is not included |
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Cost for 1-Day treatment (medication and examinations are not included) |
20,000 |
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Cost for 2-Day treatment (medication and examinations are not included) |
40,000 |
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Cost for 3-Day treatment (medication and examinations are not included) |
60,000 |
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Cost for 4-Day treatment (medication and examinations are not included) |
80,000 |
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Cost for 5-Day treatment (medication and examinations are not included) |
100,000 |
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Cost for 1-Day treatment (including medication, without examinations |
30,000 |
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Cost for 2-Day treatment (including medication, without examinations |
60,000 |
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Cost for 3-Day treatment (including medication, without examinations |
90,000 |
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Cost for 4-Day treatment (including medication, without examinations |
120,000 |
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Cost for 5-Day treatment (including medication, without examinations |
150,000 |
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Day-time inpatient treatment (medication and examinations are not included) |
115,000 |
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Inpatient treatment of the patient |
175,000 |
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Inpatient treatment with concomitant disease |
215,000 |
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Inpatient treatment with concomitant disease and/or complications |
265,000 |
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Inpatient treatment complicated, with impairment of the function of the vital organs |
315,000 |
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Treatments for severe somatic symptom disorder including non-profile examinations |
515,000 |
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Reimbursement of additional medicine, based on the actual costs incurred |
1,000 |
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Reimbursement of additional medicine, based on the actual costs incurred 1 |
5,000 |
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Reimbursement of additional medicine, based on the actual costs incurred 2 |
10,000 |
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Other inpatient service |
Price (AMD) |
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Pacemaker implantation FAILED |
500,000 |
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Left ventricular electrode implantation FAILED |
375,000 |
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Diagnostic procedure FAILED |
375,000 |
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Cost of paid hospital rooms |
Price (AMD) |
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Individual hospital-room |
10,000 |
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Bardyarrythmias treatment (other) |
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Pacemaker implantation other |
Price (AMD) |
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Pacemaker repositioning UNCLASSIFIED, simple cases |
1,150,000 |
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ICD electrode repositioning, simple cases |
1,250,000 |
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Left ventricular electrode repositioning, simple cases |
1,100,000 |
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Atrial electrode repositioning, simple cases |
1,100,000 |
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Right ventricular electrode repositioning, simple cases |
1,100,000 |
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Wound revision, simple cases |
1,100,000 |
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Subcutaneous pocket preparation, simple cases |
1,100,000 |
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Pacemaker explantations /extractions |
Price (AMD) |
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Pacemaker explantation, simple cases |
745,000 |
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Cardioverter-Defibrillator Explantation , simple cases |
745,000 |
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Resynchronization devices explantation for ventricular contraction, simple cases |
745,000 |
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Resynchronization ICD devices explantation for ventricular contraction, simple cases |
745,000 |
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Complete electrode extraction, simple cases |
850,000 |
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Incomplete electrode extraction, simple cases |
850,000 |
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Pacemaker electrode implantations |
Price (AMD) |
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Right ventricular electrode lead implantation, simple cases |
1,000,000 |
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Left ventricular electrode lead implantation, simple cases |
1,500,000 |
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Atrial Electrode Implantation, simple cases |
1,000,000 |
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Pacemaker/ICD electrode implantation UNCLASSIFIED, simple cases |
850,000 |
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Ablations |
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Paroxysmal ventricular tachycardia ablation, simple cases |
1,550,000 |
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Paroxysmal supraventricular tachycardia ablation, simple cases |
1,150,000 |
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His bundle ablation, simple cases |
1,150,000 |
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Ablation for Atrial Tachycardia, simple cases |
1,150,000 |
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Atrial fibrillation ablation, simple cases |
1,150,000 |
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Atrial fibrillation ablation (Pulmonary vein isolation), simple cases |
2,250,000 |
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Ablation, simple cases |
1,100,000 |
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Reablation, simple cases |
700,000 |
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Diagnostic mini system implantation Reveal DX, simple cases |
1,350,000 |
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