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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.

 

Erebouni Medical Center: Cardiology & Cardiac Surgery Clinic: Electrophysiology & Intervention Arrhythmology Department

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.

 

Electrophysiology & Intervention Arrhythmology Department         Electrophysiology & Intervention Arrhythmology Department

 

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
 
Equipping

Erebouni Medical Center: Cardiology & Cardiac Surgery Clinic: Electrophysiology & Intervention Arrhythmology Department

  • 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
 
Main activities

 

Study and procedures performed on an outpatient base


   

Multichannel electrocardiography (ECG),

   

Echocardiography (EchoCG),

   

Holter monitoring,

   

Event monitoring,

   

Study, diagnostics and programming of the stimulator, CVD and devices, synchronizing the work of the heart,

   

Excercise test (Treadmill test),

   

Monitoring of blood pressure,

   

Out-patient and out-going arrhythmology consultations.

 

Procedures, implementing  at the in-patient conditions


   

Mapping,

   

Electrical cardioversion

   

Pharmacological cardioversion

   

Some types of electrophysiological studies

   

Transesophageal echocardiography

    Implantation of temporary transcutaneous pacemaker.

 

Interventional procedures, conducted at the Department of electrophysiology and interventional arrhythmology


 

   

Inplantation of cardiostimulators, cardioverters – defibrillators (CVD), stimulators and cardioverters – defibrillators with heart work synchronization, and diagnostic mini-systems (Implantable Loop Recorder):

     
  • Cardiac Stimulators (Pacemaker) which are the small electronic devices that implanted in case of atrioventricular blockades and at slow heart rate, for maintenance of normal heart rate.
  • Cardioverter – defibrillator are implanted into the human’s body for the treatment of life- threatening arrhythmias,
  • Stimulators and CVD with synchronization of ventricles contraction function that are auxiliary medical devices, which are implanted for the treatment of heart failure and arrhythmias.

   

Electrophysiological studies

 

   

Radiofrequency ablation of ventricular and supraventricular arrhythmias. Ablation - is the destruction of arrhythmogenic foci. In our center performed all types of ablations. In particular:

     
  • in case of  supraventricular tachycardia::
      AV reentri,
      AV nodal reentri
  • In case of ventricular tachycardia:
      right ventricular
      left ventricular
  • Ablation of main bundle of His,
  • Ablation in case of atrial tachycardia,
      right atrial,
      left atrial,
  • Ablation in case of atrial fibrillation,
  • Atrial flutter ablation.

   

Selective angiography of the heart (coronarography) angioplasty and stenting

    Angiography of great and periferic vessels of upper and lower extremities.

 

Staff
Mihran Martirosyan,  MD, PhD Mihran Martirosyan, MD, PhD Write a letter Head of Electrophysiology & Intervention Arrhythmology Department arrhythmologist
Lianna Khachatryan, MD Lianna Khachatryan, MD Write a letter Clinical Head of Electrophysiology & Intervention Arrhythmology Department cardiologist-arrhythmologist
Mihran Martirosyan Mihran Martirosyan Write a letter cardiologist-electrophysiologist PhD
Margarita Sahakyan Margarita Sahakyan Write a letter cardiologist-arrhythmologist
Education

 

Education material for specialists

 

Education material for Patients

 

  Catheter ablation in arrhythmia
Publications
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