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THE GROUP OF CARDIAC CELLULAR ELECTROPHYSIOLOGY (School of Medicine , UCM), has the following equipment/facilities:
The group of Cardiac Cellular Electrophysiology ( School of Medicine , UCM), has the following equipment/facilities:
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Five fully equipped patch-clamp set up for recording ionic currents including patch-clamp amplifiers (Axopatch 200B, Multiclamp 700B and Axoclamp 900A), DigiData 1550 Digitizer , pCLAMP 10 Electrophysiology Data Acquisition and Analysis Software , TMC air tables, oscilloscopes, Sutter micromanipulators, Langerdorff perfusion system, rapid exchange fluid systems, Sutter micropipette puller and fluorescence microscopes.
- One equipment for recording cardiac action potentials in multicellular preparations , including oscilloscopes, WPI preamplifiers, isolation units, micromanipulators (Narishige) and Data Acquisition and Analysis Software (Cibertec, SA).
- A laboratory of molecular biology with all the needed equipment: real-time quantitative polymerase chain reaction (qPCR), PCR Thermal Cyclers , refrigerated and tabletop centrifuges, nanodrop 2000, microplate reader (Asys UVM 340) , -20ºC freezer, capture and analysis system ( KODAK Image Station 4000R Digital Imaging System).
- Cell culture room with air impeller, two incubators, laminar flow hood (Telstar) , microscopes, tabletop centrifuge, orbital shaker, refrigerator-freezer, liquid nitrogen tank, ultracentrifugers , -80º ultrafreezers, CO2 incubators , etc.
- Tissue bank fully equiped
- The Group also uses the common equipment of the Department of Pharmacology (water distiller/desionizer, autoclaves, ultracentrifuges, ice machine, -80º ultrafreezers , etc), the School of Medicine (animal stabulary) and the Research Facilities Centers of the Universidad Complutense (confocal microscopy, flow cytometry and fluorescence microscopy , mass spectrometry, nuclear magnetic resonance, bioinformatics ).
UNIVERSITY HOSPITALS OF THE ITACA CONSORTIUM
Arrhythmia and cardiac electrophysiology services are an innovative and fast-growing branch of clinical cardiology. In the Hospitals of the ITACA Consortium the Arrhythmia Units are included in the Department of Cardiology and they maintain a close collaboration with the cardiac surgery unit.
These Arrhythmia Units offer the following Portfolio of services:
Noninvasive Area:
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Arrhythmia Unit Consultation to diagnose and treat patients referred by other cardiologists or medical specialists with different clinical entities that produce rhythm disturbances.
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Follow -up of patients with implanted pacemakers, implanted cardioverter-defibrillato rs (ICD) or devices for resynchronization therapy (ICD). This follow-up can be performed personally or via telemonitoring.
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Follow-up of patients after ablation of cardiac arrhythmias
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Tilt Table Test : For the differential diagnosis of syncope of unknown origin.
Invasive Area:
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Implantation and monitoring of pacemakers, implantable ICD , subcutaneous Holter monitoring and devices for cardiac resynchronization therapy
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Implantation of loop recorders (implanted ECG recorders for long-term monitoring of ECG to allow for diagnosis of an arrhythmia)
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Electrical and pharmacological cardioversion of cardiac arrhythmias
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Pharmacological test (adenosine, ajmaline, flecainide, adrenaline) for the diagnosis and treatment of cardiac arrhythmias Diagnostic and therapeutic electrophysiological (EP) studies: different ablation systems (e.g., radio-frequency current, cryoballoon).
The Arrhythmia Units contain all the equipment needed for catheter ablation procedures and/or device implantation, including:
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An operating room.
- A fluoroscopy unit with either one or two C-arms (monoplane or biplane) to see the position and movement of the catheters inside the heart.
- Multichannel electrocardiographs to continuously acquire, store and analyze the electricalsignals of the cardiac activity ( both surface and intracardiac continuous ECG recordings ) collected by a variable number of catheters, previously introduced into the heart through a vein or artery (typically by puncture in the groin) and positioned in certain points of the heart chambers depending on the studied arrhythmia.
- Data adquisition workstations interfaced with a computer.
- Electroanatomic 3-dimensional mapping systems needed to perform complex procedures such as catheter ablation of atrial fibrillation, atrial tachycardia, or ventricular tachycardia. The hospitals of the ITACA Consortium use two different 3-dimensional mapping systems. The CARTO TM (Biosense Webster Inc., Diamond Bar, California, United States) system, that utilizes a low-level magnetic field delivered from three separate coils in a locator pad beneath the patient to allow virtual recording of the mapping catheter position and the Ensite NavX TM (St. Jude Medical, Inc., St. Paul, Minnesota, United States) system where any movement of the catheter electrodes results in a change of measured voltage and impedance of each electrode.
- A programmable stimulator which generates electrical impulses that reach the heart through the catheters with the intention of studying the heart's electrical system and induce or suppress the arrhythmia of the patients. The stimulator can also be used as temporary pacemaker when necessary .
- A generator of radiofrequency currents that produce heat in the area of contact with the tip of the ablation catheter to "burn" areas implicated in the genesis/maintenance of the tachycardia .
Close follow-up of patients who underwent complex ablation procedures or device implantations is necessary and is provided by the Arrhythmia Unit. Indeed, the U nits are equipped with monitoring systems for the continuous electrocardiographic, hemodynamic, and respiratory assessment of patients on general wards and recovery-intermediate or intensive care units. Noninvasive imaging, including transthoracic and transesophageal echocardiography and the analysis and documentation of arrhythmia burden via surface-ECG, Holter-ECG, internal or external event recorder are also available. External defibrillators and pacemakers are available in case of emergency situations.
New technologies like telemonitoring allow for daily and if necessary immediate response to patient problems as a serious arrhythmic events occur. This rapid answer demands high-quality organizational infrastructures and implies a solid network of cooperating physicians and hospitals. This is the case for the six Clinical Hospitals of the Community of Madrid participating in the ITACA Consortium, which can demonstrate that they have maintained a close working relationship over the last years .
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