DEPARTMENT OF X-RAY SURGICAL AND INTRAOPERATIVE ARRHYTHMIAS DIAGNOSTICS AND TREATMENT (DXRSIADT)

Patients with different rhythm disturbances are treated in the Department of X-ray surgical and intraoperative arrhythmias diagnostics and treatment (DXRSIADT). Pre-operative and intra-operative electrophysiological examinations and arrhythmias mapping are performed here.
X-ray operating rooms of the Center are equipped with high-resolution three-dimensional navigation mapping systems that allow to determine the location of catheters in the heart with high accuracy (up to 1 mm) and instantly process electro-anatomical information. Specialists find the location of the key zone as precisely as possible, apply a concentrated, predictable impact of destructive energy to prevent subsequent recurrences of rhythm disturbances, both in primary patients and in previously operated patients.
Radiofrequency ablations, cryoablations, implantations of pacemakers and cardioverter-defibrillators, left atrial appendage closure and other interventional procedures are performed according to the highest advanced world standards, with the most predictable results and with the least number of complications.

• the study of the effectiveness of RFA of ectopic arrhythmogenic foci in the right and left atria as a predictor of the development of atrial fibrillation in young patients with atrial tachycardias;
• the use of multipolar mapping electrodes for diagnostics, interventional and surgical treatment of atrial fibrillation;
• the study of the electromechanical properties of the atria in patients with atrial fibrillation, arterial hypertension and chronic kidney disease;
• the study of the electromechanical properties of the atria in patients with recurrent atrial fibrillation after interventional treatment;
• hybrid treatment methods for life-threatening arrhythmias and atrial fibrillation;
• the assessment of long-term results of non-pharmacological treatment of atrial fibrillation using implantable long-term monitoring devices;
• the use of intra-operative epicardial mapping for the diagnostics and treatment of heart rhythm disturbances;
• the use of three-dimensional epicardial mapping for diagnostics and treatment of life-threatening arrhythmias and atrial fibrillation.

• The use of non-fluoroscopic high-density navigation mapping for treatment of patients with various heart rhythm disturbances
• Electroanatomical map of the left atrium endocardial surface obtained using the Orion multipole electrode
• Optimizer - a device for the treatment of low cardiac output syndrome
• Simultaneous endo-/epicardial atrial mapping
• Cryoablation of the pulmonary vein in patients with atrial fibrillation
• Epicardial mapping and radiofrequency ablation of ectopic foci of ventricular heart rhythm disorders
• Clinical testing: “Clinical testing of the method of treatment of incisional arrhythmias in patients after congenital heart diseases repair”
• Clinical testing: “Isolation of pulmonary vein ostia with cryoballoons of the fourth generation for the treatment of patients with various forms of atrial fibrillation (I48) to evaluate its effectiveness compared with isolation of pulmonary veins with cryoballoons of previous generations using the national ECG home monitoring system”
• Clinical testing: “Method of catheter ablation based on omnipolar mapping in patients with incisional arrhythmias (I48) after congenital heart diseases repair using a catheter with the possibility of optical measurement of contact strength with the myocardium, compared with classical catheter ablation”
• Clinical testing: “Automatic localization of arrhythmogenic zones for the treatment of patients with persistent atrial fibrillation compared with standard electroanatomical mapping. I48.1"

Since 2012, 19,489 operations have been performed, 16,157 of them were radiofrequency ablation (RFA), more than 500 of which were cryoablations, 2,920 pacemakers were implanted, 417 cardioverter-defibrillators were implanted, more than 23,000 electrophysiological examinations were performed.