Which Arrhythmias and Diagnostic Tests Are Handled by the AF-ABLATION Department?

Updated

AF-ABLATION (the Department of Arrhythmia and Electrophysiology, led by Prof. Carlo Pappone) covers the full range of arrhythmia care: catheter ablation for atrial fibrillation, atrial flutter, WPW, AVNRT, atrial tachycardia, PVCs, ventricular tachycardia and Brugada syndrome; implantation and follow-up of pacemakers, ICDs, S-ICDs, CRT devices and loop recorders; and a diagnostic service that runs from basic ECG and Holter monitoring through echocardiography, cardiac MRI and coronary CT to electrophysiological studies and provocative drug testing. The sections below set out what each service is for, so you can judge which one matches a given referral question.

Ablation Procedures

The electrophysiology laboratory performs transcatheter ablation for both atrial and ventricular arrhythmias. The centre lists the following targets:

  • Atrial fibrillation (AF) ablation — including pulse field ablation (PFA), the non-thermal technique highlighted on the site's homepage.
  • Atrial flutter (AFL) ablation
  • Atrio-ventricular abnormalities (WPW) ablation — accessory pathway ablation.
  • AV nodal reentrant tachycardia (AVNRT) ablation
  • Atrial tachycardia ablation
  • Ventricular extrasystoles (PVC) ablation
  • Ventricular tachycardia (VT) ablation
  • Substrate ablation of Brugada syndrome — reflecting the department's stated research focus on Brugada syndrome, long QT syndrome and other genetic heart diseases.
  • Ablation and modulation of the atrio-ventricular node

The laboratory also documents the mapping systems and anaesthetic management used during these procedures, which is useful if you need to know what to expect on the day.

Implantable Devices

Device work spans implantation and ongoing management:

Device Listed as
Pacemaker PMK
Implantable cardioverter defibrillator ICD
Subcutaneous defibrillator S-ICD
Resynchronisation therapy CRT-D and CRT-P
Wireless pacemaker Leadless pacing
Implantable loop recorder Long-term rhythm monitoring

Follow-up is supported by remote monitoring of cardiac devices and a dedicated information page for patients with implants, plus information from the manufacturing companies.

Outpatient Diagnostics

The diagnostic pathway starts with basic rhythm recording and moves to imaging and invasive testing only where needed:

  • ECG — standard 12-derivation recording.
  • Holter — dynamic ECG monitoring.
  • Stress test and tilt test.
  • Late potentials and cardiotelephone.
  • Echocardiography — transthoracic, transoesophageal, and with provocative testing.
  • Cardiac magnetic resonance.
  • Coronary AngioTAC (coronary CT angiography).
  • Arrhythmological visits and outpatient implantable device checks.
  • Psychology service — listed alongside the diagnostic services.

Electrophysiological Studies and Provocative Tests

For patients where the diagnosis is unclear or a genetic arrhythmia syndrome is suspected, the department offers:

  • Electrophysiological study — invasive mapping of the heart's electrical behaviour.
  • Provocative pharmacological tests — with ajmaline (or flecainide), isoproterenol, adenosine, and adrenaline.
  • Electrical cardioversion (ECV) for restoring normal rhythm.

These are the tests most relevant to inherited conditions such as Brugada syndrome and long QT syndrome, which the centre names as a core research area.

Other Listed Services

The department also lists percutaneous occlusion of the atrial appendage, pharmacological therapies (antiarrhythmic and anticoagulant drugs, with NAO guidance including suspension for surgery and dosing in chronic kidney failure), and a list of medications to avoid.

How to Use This to Decide

If the question is which service fits a symptom or referral, work from the least invasive option outward: a standard ECG or Holter answers most rhythm questions; echocardiography or cardiac MRI addresses structural causes; electrophysiological study and drug testing are reserved for diagnostic uncertainty or suspected genetic syndromes; ablation and devices are therapeutic steps that follow a confirmed indication. The department's contact details — +39 02 36552440, Piazza Edmondo Malan 2, San Donato M.se – Milano — and its appointment and information request channels are the route for confirming which pathway applies to a specific case.