Clinical Unit of Electrophysiology and Electrostimulation

Head: Professor Davor Puljević, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Head Nurse: Danijela Krnjić, bacc. med. techn.

Cardiology specialists:

Professor Davor Puljević, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Assistant professor Vedran Velagić, MD, PhD, Internal Medicine Specialist, Cardiology Subspecialist
Primarius Borka Pezo Nikolić, MD, Internal Medicine Specialist, Cardiology Subspecialist
Richard Matasić, MD, Internal Medicine Specialist, Cardiology Subspecialist

The unit consists of electrophysiological study procedure room and operating room for implantation of the heart pacemakers.

Electrophysiological procedures are complex invasive procedures involving, two electrophysiologists, instrumental nurses, and X-ray engineers. Since 2015, the electrophysiological laboratory has moved to a new, top equipped electrophysiological room, that enables performing highly complex electrophysiological procedures. Since then, the number of completed interventions has increased rapidly, especially complex procedures, which now make 40% of the total number of interventions. In addition to radiofrequency ablation, first cryoballoon ablation for pulmonary vein isolation of atrial fibrillation in Croatia was performed at the Department. Today this is routine procedure. In our Unit radiofrequency ablation of ischemic ventricular tachycardia was performed for the first time in Croatia, as well as first epicardial ablation of ventricular ectopy. In cooperation with the Paediatric Department, we perform procedures in children older than 10 years. Also, children with simpler natural defects (Ebstein's anomaly, Tetralogy Fallot, ASD, VSD) are being treated.
Particular attention is paid to the safety of patients and staff. The new X-ray device regulates the amount of radiation (the procedures are performed with a lower number of pulses / sec), which significantly reduces X-ray radiation of the patient. The device provides the ability to perform rotational angiography, which in combination with CARTO3D magnetic navigation and intracardial ultrasound provides a better insight into the anatomy and electrophysiology of the patient, which maximally reduces complications and increases the effectiveness of the procedure.

• Diagnosis of Accidental Heart Disease, Ajmaline Test
  
• Diagnosis of bradycardia disorders
  
• Diagnostics and Ablation:
  
• Supraventricular Tachycardia:
  • Atrioventricular nodal circular tachycardia (AVNRT)
  • Wolf-Parkinson-White Syndrome (WPW syndrome, AVRT)
  • Atrial Tachycardia (AT)
  • Undercover atria (UA)
  
• Ventricular Tachycardia:
  • Ventricular Tachycardia (VT) and Ventricular Extrasystoles (VES) (with or without myocardial disease) (CARTO3D navigation)
  
• Atrial fibrillation (AF) (cryoablation and RF ablation with CARTO3D navigation)
  

The Laboratory for pacemakers is the leading laboratory for implanting electrostimulation devices.
One-chamber, two-chamber, and resynchronization (CRT) devices are implanted. Implantable cardioverter defibrillators (ICD) are implanted for the purpose of primary and secondary acute cardiac death prevention. A total of about 500 pacemakers, 150 cardioverter defibrillators and 70 resynchronization - CRT devices are implanted annually.
The extraction of non-functional electrodes is also performed in the Laboratory.
Recently, telemedicine monitoring systems for patients with certain categories of electrostimulation devices have been introduced in the Laboratory. Practically all our patients remain in permanent follow-up at the Outpatient Clinic after implantation.