p. 1

international arrhythmia center pbx 571 667 2727 extensions 3136 y 3162 mobil 57 316 395 3949 317 367 5546 e-mail arritmias@cardioinfantil.org administrative and patient referral matters pacientearrhythmias@cardioinfantil.org ­ information for patients www.arrhythmiasfci.org address calle 163 a 13b-60 bogota colombia andrea natale every time you use the services of fundación cardioinfantil you help us save the lives of poor children with heart disease there are no boundaries to our care for your heart s electrical rhythm www.cardioinfantil.org

[close]

p. 2

andrea natale international arrhythmia center the andrea natale international arrhythmia center is a service of the institute of cardiology fundación cardioinfantil conformed by an interdisciplinary group of recognized physicians nurses and technicians who specialize in the care of patients with cardiac electrical rhythm disorders also known as arrhythmias its infrastructure and organization are designed to facilitate access by domestic and foreign patients to specialized treatments for the management of all types of arrhythmias as such it is recognized as a regional and national referral center for the study and treatment of patients of all age groups who suffer diseases of the heart s electrical system supported by the latest-generation technology and logistics which enable it to achieve the highest standards for safety and effectiveness with the efficiency and comfort of a world-class service.

[close]

p. 3

medical team the andrea natale international arrhythmia center of the institute of cardiology fundación cardioinfantil is comprised of a medical team of regionally and nationally renowned electrophysiologists who specialize in the study and treatment of cardiac arrhythmias these specialists are founding members of the colombian college of electrophysiology and current members of the heart rhythm society they have participated in different multicenter research studies co-authored several peer reviewed articles in internationally renowned journals and textbooks and are regular guest speakers at international symposia where they have the opportunity to share their advances and experiences the medical team is supported by a group of specialized nurses and technicians with extensive training and expertise in state of the art medical equipment and management protocols used for the treatments provided.

[close]

p. 4

dr luis carlos sÁenz morales physician and surgeon universidad nacional de colombia internist hospital de la samaritana pontificia universidad javeriana cardiologist fundación cardioinfantil-ic universidad del bosque electrophysiologist hospital clinic de barcelona universidad de barcelona spain research fellow cleveland clinic ohio diplomate in clinical epidemiology pontificia universidad javeriana director fci-ic international arrhythmia center dr francisco villegas garcÍa physician and surgeon universidad pontificia bolivariana medellín colombia internist universidad pontificia bolivariana medellín colombia cardiologist clínica cardiovascular santa maría universidad pontificia bolivariana medellín colombia electrophysiologist fundación clínica shaio pontificia universidad javeriana bogotá colombia dr diego andrÉs rodrÍguez guerrero physician and surgeon universidad nueva granada internist hospital san ignacio pontificia universidad javeriana cardiologist fundación clínica shaio universidad del bosque electrophysiologist fundación clínica shaio universidad de la sabana diplomate in clinical epidemiology pontificia universidad javeriana fellowship program director fci-ic international arrhythmia center dr alvaro arenas auli physician and surgeon universidad del bosque pediatrician hospital lorencita villegas de santos universidad del rosario pediatric cardiologist universidad de chile pediatric electrophysiologist universidad de chile.

[close]

p. 5

technology currently the andrea natale international arrhythmia center has two large angiography suites meeting the highest quality and safety standards and fully equipped with state of the art technology for performing procedures to study and treat simple and complex arrhythmias all rooms are equipped with intra-cardiac ultrasound machines and both ensite® and carto 3® mapping systems the latter was one of the first to be installed in latin america this equipment combined with the most advanced computer tomography ct and cardiac magnetic resonance imaging mri technology for image integration allows for minimal intra-procedural x-ray use by creating a very precise 3-d reconstruction of the cardiac anatomy which combined with electrical data provides accurate electro-anatomical maps to identify and treat the structures causing an arrhythmia this technology also enables highly accurate real-time visualization of the catheter tip as it is advanced into the heart and positioned to cauterize these structures through the application of radiofrequency energy ablation which is used for the treatment of different types of arrhythmias the precise positioning and proper contact of the ablation catheter with the structures to be cauterized are the key factors that determine effectiveness and safety of these procedures as well as the amount of x-ray radiation the patient will be exposed to.

[close]

p. 6

3 invasive tests a electrophysiologic studies 4 electrical cardioversion 5 implantation of cardiac stimulation devices including explantation a b c d pacemakers implantable cardiac defibrillators icds cardiac resynchronizers crt-p and crt-ds implantable event monitors services at the international arrhythmia center of the institute of cardiology fundación cardioinfantil in addition to taking a complete clinical history and performing a physical examination of the patient we conduct all tests and treatments that are recognized for the study and management of all types of arrhythmias in patients of all ages under the highest quality standards and using the most modern technology available worldwide 6 ablation of all types of arrhythmias a conventional ablation which is mainly x-ray guided and is used in patients with non-complex tachycardias and does not require a detailed definition of the cardiac anatomy this category includes ablations of nodal reentrant tachycardia accessory pathway tachycardia cavotricuspid isthmus-dependent right atrial flutter in patients with no history of cardiac surgery b ablation guided with 3d mapping and intra-cardiac ultrasound this category includes all other arrhythmias which because of their instability and complexity require a very detailed and precise definition of the cardiac anatomy not feasible with conventional x-rays this group includes study and ablation of atrial and ventricular extrasystoles atrial tachycardia non-cavotricuspid isthmus-dependent atrial flutter or atrial flutter in patients with a history of cardiac surgery atrial fibrillation ventricular tachycardia with endocardial and epicardial mapping unsuccessful ablation of non-complex tachycardias using conventional x-ray-guided technology or specific non complex-arrhythmias where for safety or effectiveness reasons require a more detailed and precise definition of the cardiac anatomy 1 referrals a referrals for arrhythmia diagnosis and management b referrals to reprogram all brands of implantable cardiac devices pacemakers implantable cardiac defibrillators icds cardiac resynchronizers crt-p and crt-ds implantable event monitors 2 non-invasive tests a b c d e f conventional 12-lead electrocardiogram signal-averaged electrocardiogram 24-hour holter test 7-to-14-day holter test non-invasive event monitoring tilt table test autonomic function tests

[close]

p. 7

atrial fibrillation ablation atrial fibrillation af is the most common arrhythmia and is associated with deterioration in quality of life due symptoms such as palpitations fatigue and an increased risk of heart failure thrombosis and death the effectiveness of therapy with anti-arrhythmic medications to try to return the patient to a normal rhythm and maintain it is limited and is associated with undesirable side effects for this reason various types of invasive treatments have been developed in order to provide a more definitive control of the arrhythmia such as af ablation also known as pulmonary vein isolation or pvi in which ablation cauterization with catheters is performed on specific structures inside the heart which are involved in the origin of the arrhythmia in a large proportion of patients the accurate identification of these structures is one of the determining factors of the success and safety of this therapy af ablation is one of the most frequently performed procedures for local and foreign patients at the andrea natale international arrhythmia center and its treatment benefits from the most modern technology and the vast experience of the center s medical group.

[close]

p. 8

ventricular arrhythmia ablation ventricular arrhythmia can be life threatening especially when it occurs in patients suffering from heart disease that has significantly reduced the hearts contractile function invasive ablation cauterization treatment may be indicated when this arrhythmia occurs frequently despite medical treatment with anti-arrhythmic drugs treatment of this type of arrhythmia with ablation requires not only a vastly experienced medical group and the use of state-of-the-art technology to obtain 3-d images to guide the procedure 3-d mapping and intra-cardiac ultrasound but also optimal institutional support that meets the multiple needs of critically ill patients the andrea natale international arrhythmia center is one of the few centers in south america central america and the caribbean that has developed an invasive strategy for the interventional management of patients with ventricular arrhythmia and it is recognized as a regional and national reference center for performing ablation of this type of arrhythmia using an endo-epicardial technique that has saved the lives of a significant number of patients.

[close]

p. 9

results in 2010 the andrea natale international arrhythmia center of the institute of cardiology fundación cardioinfantil assessed more than 3,000 patients and performed 2,097 holter tests and 695 tilt table tests in that same year it implanted more than 350 cardiac rhythm devices and performed around 400 ablations half of which corresponded to complex ablations requiring 3-d mapping and intra-cardiac ultrasound such as atrial fibrillation ablation pulmonary vein isolation and ventricular tachycardia ablation the effectiveness and safety of these procedures at fci are similar to those reported by other internationally renowned centers the results in the atrial fibrillation line are shown in the following tables of note is the low number of complications recorded despite the complexity of the cases as well as the very low patient exposure to x-ray radiation which is currently around 15 minutes per procedure these results are achievable due to our group s experience in the use of the 3-d mapping and intra-cardiac ultrasound technology routinely used at the andrea natale international arrhythmia center to perform this type of procedures.

[close]

p. 10

table 1 effectiveness rate of af ablations by type table 2 safety rate of af ablations by type type of atrial fibrillation paroxysmal chronic first procedure international standard 85 65 iac 82 62 second procedure international standard 90 80 iac 91 75 complication death atrio-esophageal fistula embolism cardiac perforation with tamponade arteriovenous fistula superior vena cava stenosis significant pulmonary vein stenosis moderate to severe hematoma 0 0 0 0.6 0.6 0 0 1.3 iac andrea natale international arrhythmia center average x-ray exposure per procedure 15 minutes corresponds to 1 patient who required only puncture drainage corresponds to two patients with moderate hematomas who required only observation.

[close]

p. 11

specialized in the care of international patients for many years the institute of cardiology fundación cardioinfantil has been a national and international reference center for the care of patients with cardiovascular disease consequently an ever-growing number of patients of all ages from the andean region central america and the caribbean have visited the institution in search of specialized treatment for arrhythmias of all types of complexity to ensure the achievement of the highest quality standards in the care of colombian and international patients the andrea natale international arrhythmia center has optimized its communications with patients their families and their referring doctors using a web solution www.arrhythmiasfci.org where referring physicians can request opinions from our medical staff in order to discuss and resolve specific cases have access to information concerning procedural indications techniques pre-surgical preparation and oversight for post-operative monitoring the center is supported by bilingual nurses and doctors who are dedicated exclusively to assisting with all referral and hospital admission paperwork in-hospital stay discharge and monitoring procedures for our foreign patients international patients evaluated and treated in the andrea natale international arrhythmia center 117 120 59 32 2008 2009 2010 2011

[close]

p. 12

we are prepared to help you at any time you may contact us for additional information or to request any of the services provided by the andrea natale international arrhythmia center of the institute of cardiology fundación cardioinfantil international alliances for a second opinion we currently offer consultative services with world class opinion leaders such as drs andrea natale and fermín garcía the international consultation service provided by the iac at the fci-ic aims to maintain the highest standards in technology and patient care allows for frequent academic exchanges and updating and provides an opportunity for medical boards to analyze complex cases of domestic and foreign patients through video conferencing with the acive participation of these renowned physicians dr andrea natale executive medical director cardiac arrhythmia institute at st david´s medical center austin texas consulting professor cardiology division stanford university palo alto california dr fermín garcía cardiac electrophysiology program hospital of the university of pennsylvania philadelphia scientific medical team dr luis carlos sáenz morales head of the service lcsaenz@cardioinfantil.org dr francisco villegas fvillegas@cardioinfantil.org dr diego andrés rodríguez guerrero drodriguez@cardioinfantil.org dr alvaro arenas auli aarenas@cardioinfantil.org

[close]