Department of clinical electrophysiology

Department of clinical electrophysiology represents a special unit, which has many years of unique clinical experience in treating patients with different forms of cardiac arrhythmias and syncope. Laboratory of interventional diagnostics, treatment of cardiac rhythm disorders and syncope is an important structural subdivision of the Department.7th clinical department offers 47 single and double wards, where full-time clinical work is performed.

Department employees perfectly apply new invasive and non-invasive diagnostic tools to accurately differentiate cardiac arrhythmias and evaluate rhythm and conduction disorders at its earliest stages providing patients with effective treatment and prophylaxis methods.

Department accumulates vast experience of differential diagnostics in patients with syncope. To identify arrhythmic and other causes of syncope, our department frequently performs passive orthostatic tests, so called tilt-table tests, modified exercise-stress tests, cardiac electrophysiological studies, 24-hour ECG monitoring, implantable loop recorders and other methods. Examination results provide patients with individual methods of interrupting syncope recurrences.

One of the main department therapeutic directions is medical antiarrhythmic therapy controlled by 24-hour ECG monitoring, intracardiac and transesophageal electrophysiological studies. Traditional and new highly effective antiarrhythmic drugs are used in treating patients with cardiac rhythm disorders. It should be noted, that antiarrhythmic drugs, such as etmozin, ethacyzin and allapinin were introduced in clinical practice based on the results of clinical trials, performed at our department.

Refralon, a new class III antiarrhythmic drug was investigated in 7th clinical department. After finishing all clinical trial stages, it demonstrated a high antiarrhythmic effect, allowing to pharmacologically restore sinus rhythm without electrical cardioversion, even in patients with persistent atrial fibrillation. Refralon was registered in 2014 in Russian Federation and recommended as a pharmacological agent to restore sinus rhythm in patients with atrial fibrillation and flutter. In patients with persistent atrial fibrillation and flutter no other drugs demonstrate the comparable efficacy, which is very close to the efficacy of electrical cardioversion.

Advanced non-pharmacological methods of arrhythmia treatment are widely used in the department. A full-equipped electrophysiology lab and intensive care unit carry out a wide range of modern interventional treatment options in patients with cardiac rhythm and conduction disorders.

We have a large experience in catheter ablation of the most common cardiac rhythm disorders: AV-nodal reentry tachycardia, WPW-syndrome tachycardia, atrial tachycardia, atrial fibrillation, atrial flutter, ventricular premature beats and some forms of ventricular tachycardias. Department employees introduced into clinical practice one of the most effective and safe atrial fibrillation treatment methods –catheter cryoballoon pulmonary vein ablation (isolation). Cryoablation allows to achieve a long-lasting antiarrhythmic effect (without prescribing further antiarrhythmic drugs) in a major part of patients with paroxysmal and persistent atrial fibrillation.

Patients with bradyarrhythmias and conduction disturbances are treated with all types of available implantable devices: single- and dual-chamber pacemakers, biventricular pacemakers (CRT, CRT-D), used for cardiac resynchronization therapy in heart failure patients. Patients with life-threatening ventricular arrhythmias and other patients at high risk of sudden cardiac death are directed to cardioverter defibrillator implantation (ICD).

Department also includes an ambulatory consultative cabinet, equipped with high-tech diagnostic tools. It provides patients with qualified expert consultations and gives recommendations on further treatment of cardiac rhythm and conduction disorders.

Each year department organizes educational courses: “Current arrhythmia issues: Mechanisms, diagnostic and treatment questions in patients with cardiac rhythm disorders”, consisting of lectures, seminars and clinical cases. This course is dedicated to new approaches in diagnosis, therapy of cardiac rhythm and conduction disorders, syncope and to their pharmacological and non-pharmacological treatment.