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What is AF-ABLATION?
AF-ABLATION is the arrhythmia and electrophysiology department site associated with Prof. Carlo Pappone, based at Piazza Edmondo Malan 2 in San Donato Milanese, near Milan, with further clinical locations at San Raffaele in Milan and Villa Ruesch in Naples. It presents itself as a centre for catheter-based treatment of heart rhythm disorders and for research into the genetics ("omics") of inherited conditions such as Brugada syndrome and long QT syndrome.
What the site actually covers
The site is organised less as a general patient portal and more as a directory of what the unit does, split into three practical areas:
- Outpatient diagnostics — arrhythmological visits, ECG, Holter and stress testing, tilt test, echocardiography (including transoesophageal and provocative testing), cardiac MRI and coronary CT.
- Procedures — transcatheter ablation for atrial fibrillation, atrial flutter, WPW, AVNRT, atrial tachycardia, PVCs and ventricular tachycardia, plus substrate ablation for Brugada syndrome, AV node modulation, electrical cardioversion and percutaneous left atrial appendage occlusion.
- Devices — pacemakers, ICDs, subcutaneous defibrillators, CRT, leadless pacemakers and implantable loop recorders, with a remote-monitoring service.
There are also sections on drug therapy (antiarrhythmics, anticoagulants, NAO handling around surgery and in kidney failure), lists of medications to avoid, informed-consent documents, and a publications and blog area. The page also highlights Pulse Field Ablation (PFA) for atrial fibrillation, a non-thermal ablation technique.
Who it is for
Two audiences are served at once. Patients and referring physicians can use the diagnostics and procedure pages to understand what an evaluation involves and to request an appointment or information by phone (+39 02 36552440). Clinicians and researchers are addressed through the publications, the mapping-systems section and the inherited-arrhythmia research focus.
Practical next step
If you are weighing up where to be assessed for atrial fibrillation or a suspected inherited arrhythmia, start with the procedure page that matches your referral question — for example the AF ablation or Brugada substrate ablation page — and note which diagnostics that pathway requires, since the site lists them separately. Then use the contact details to confirm which location (San Donato, San Raffaele or Naples) handles your case. As general advice rather than a claim about this centre: for a complex or inherited arrhythmia, ask specifically about the volume of the relevant procedure and about genetic counselling, since those are the details that distinguish centres most clearly.
How do I request an appointment or contact the center for an arrhythmia consultation?
To book an arrhythmia consultation at this center, use the contact details listed on its site: call +39 02 36552440, or use the Request Appointment and Request Information options in the site menu. The center is located at Piazza Edmondo Malan 2, San Donato M.se – Milano. The listing also names Prof. Carlo Pappone and a clinical team, but the site does not publish online booking hours or a direct email address, so the phone line is the most reliable first step. See AF-ABLATION for the current menu and contact page.
What to prepare before you call
- Reason for the visit: palpitations, a known arrhythmia such as atrial fibrillation, fainting, or follow-up after an ablation or device implant.
- Existing records: ECGs, Holter or event-monitor reports, echocardiogram results, and a list of current medications, including anticoagulants.
- Referral details: whether your cardiologist is referring you and any preferred physician.
- Practical points: your preferred language, whether you need remote monitoring checks, and whether you are traveling from outside Italy.
A realistic scenario
A patient with paroxysmal atrial fibrillation who has already had a Holter showing episodes would call the number, state the diagnosis and ask which outpatient arrhythmology visit applies, then ask what records to send ahead. Someone seeking a second opinion on ablation suitability should say so explicitly, since the center lists dedicated AF ablation, atrial flutter, WPW, AVNRT and ventricular tachycardia services, and the appointment type may differ.
Decision criteria
Choose the phone route if you need an appointment confirmed quickly or have a complex history. Use the information request if your question is about which service fits or what to bring. For urgent symptoms such as fainting, chest pain or sustained palpitations, seek emergency care rather than waiting for an outpatient slot.
Is pulse field ablation (PFA) a suitable treatment option for my atrial fibrillation compared with other ablation methods?
Yes—PFA is a reasonable option to discuss for atrial fibrillation, but suitability depends on your AF pattern, heart structure, prior procedures and anaesthetic considerations. The AF-ABLATION site at San Raffaele lists PFA under its AF ablation programme alongside conventional transcatheter ablation, so it is presented as part of a broader ablation service rather than a single technique for everyone.
Where PFA fits compared with other methods
| Consideration | PFA | Thermal methods (radiofrequency or cryoablation) |
|---|---|---|
| What it does | Delivers short electrical pulses intended to disable heart tissue causing AF | Uses heat (radiofrequency) or cold (cryo) to create lesions |
| Typical appeal | Tissue-selective energy, so surrounding structures such as the oesophagus and phrenic nerve are less exposed than with thermal energy | Long-established; extensive evidence base and operator familiarity |
| Trade-offs to discuss | Newer technique; not every centre offers it; long-term outcomes in your AF subtype matter | Thermal injury to nearby structures is a recognised concern; procedure time and lesion strategy vary |
| Best conversation point | Whether your AF type and anatomy make PFA preferable | Whether a proven thermal approach is equally appropriate for you |
A practical way to decide
Ask the electrophysiologist three things: your AF pattern (paroxysmal or persistent), whether your left atrium is enlarged or scarred, and whether you have had a previous ablation. These factors usually matter more than the energy source alone. Also ask what the centre's own experience and follow-up look like for PFA versus thermal ablation, and what anaesthetic plan is proposed—the site lists anaesthetic management of electrophysiology procedures as part of its service, which is relevant if sedation or general anaesthesia is a concern for you.
As a next step, prepare a short list for a consultation: your symptom burden, current antiarrhythmic and anticoagulant drugs, prior cardioversions, and any implanted device. If you want to compare centres, look at AF-ABLATION for its AF ablation and PFA information, and at a major heart-rhythm society such as European Society of Cardiology or American Heart Association for patient-level guidance on AF treatment choices.
What is the process for getting tested for Brugada syndrome or long QT syndrome at this center?
Testing for Brugada syndrome and long QT syndrome at this centre begins with a specialist arrhythmology assessment rather than a self-referred lab test. The site lists arrhythmological visits and outpatient diagnostics, including 12-lead ECG, Holter monitoring, stress testing and echocardiography, alongside provocative pharmacological testing—specifically an ajmaline (or flecainide) challenge and tests with isoproterenol, adenosine and adrenaline. These drug challenges are the part most relevant to uncovering Brugada syndrome, since the resting ECG can look normal.
A practical route
- Request an arrhythmology visit. Contact the centre by phone or through its appointment and information request channels to describe symptoms, family history of sudden cardiac death, or a known genetic diagnosis. A referral from your cardiologist or GP helps prioritise the case.
- Bring prior records. Old ECGs, Holter reports, genetic test results and family history details let the specialist decide whether a drug challenge is warranted.
- Undergo baseline diagnostics. Expect an ECG and possibly Holter, stress test or echocardiography before any provocation test.
- Provocative testing, if indicated. The ajmaline/flecainide test is performed under medical supervision with continuous ECG monitoring, typically in a day-hospital or electrophysiology setting because of the small risk of inducing arrhythmia.
- Genetic counselling and family screening. The centre's stated research focus on the omics of Brugada and long QT syndromes means genetic evaluation is part of its clinical model; relatives may then be offered cascade testing.
What to expect and how to prepare
The drug challenge takes under an hour of monitoring but requires preparation: ask in advance which medications to stop and for how long, arrange someone to accompany you, and confirm fasting instructions. For long QT syndrome, bring any prior QT measurements and a list of all drugs you take, since many common medicines prolong the QT interval.
Choosing where to be tested
| Situation | Sensible priority |
|---|---|
| Fainting episodes, family history of sudden death | Centre with on-site electrophysiology backup and drug-challenge experience |
| Known mutation, asymptomatic | Genetic counselling plus rhythm monitoring |
| Borderline ECG, no symptoms | Specialist interpretation before any provocation test |
For a second opinion or comparison, major centres such as Mayo Clinic or European Society of Cardiology publish patient guidance on inherited arrhythmia evaluation. The immediate next step is to call the centre to book an arrhythmology consultation and ask what records and medication adjustments are needed beforehand.
Which ablation procedure is used for my specific arrhythmia, such as atrial flutter, AVNRT, or ventricular tachycardia?
The site lists a dedicated ablation procedure for each of these arrhythmias, so the right choice depends on which rhythm you actually have, not on a single "best" technique.
Matching procedure to arrhythmia
- Atrial flutter (AFL): the site lists a separate AFL ablation, distinct from atrial fibrillation ablation. Typical flutter is usually targeted with a focused lesion set in the right atrium, which is generally a shorter, more contained procedure than AF ablation.
- AVNRT: listed as its own ablation procedure. This is usually a small, precisely targeted lesion near the AV node, and it is one of the higher-success, lower-risk ablations when the diagnosis is clear.
- Ventricular tachycardia (VT): the site separates VT ablation from "substrate ablation," which matters because VT in structurally normal hearts and VT in scarred hearts are approached differently.
- Atrial fibrillation (AF): listed separately, with a page on pulse field ablation (PFA), a newer energy source alongside conventional thermal ablation.
What to ask before deciding
- Confirm the diagnosis first. AVNRT, flutter and VT can feel similar to patients but need different mapping. Ask whether an electrophysiology study is needed to confirm the mechanism.
- Ask which energy source and mapping system would be used for your case, and why.
- Ask about the intended endpoint (for example, non-inducibility) and what follow-up monitoring is planned.
- Ask about your own risk profile — age, heart structure and other conditions change the risk-benefit balance far more than the label of the procedure.
A practical next step: bring your ECG or Holter recordings to a consultation and ask for the mechanism to be named explicitly. The centre's own pages on AF-ABLATION set out its electrophysiology laboratory and procedure list if you want to compare options before booking.
What remote monitoring options are available for patients with implanted pacemakers, ICDs, or loop recorders?
The site lists remote monitoring of cardiac devices as a distinct outpatient service, alongside in-clinic device checks for pacemakers, implantable cardioverter defibrillators (ICDs), subcutaneous ICDs, resynchronisation devices and implantable loop recorders. It also provides a separate information page specifically for remote monitoring of implantable devices, which is the natural place to confirm which device types are supported and how transmissions are scheduled. Details such as transmission frequency, the home transmitter or app used, and alert handling are not specified on the page, so they should be confirmed directly with the centre.
What this means in practice
- Pacemaker or ICD patients typically use remote monitoring for routine follow-up between in-person visits, with clinic checks reserved for programming changes, battery issues or suspected problems. The centre's "Visits and Outpatient Diagnostics" section covers both pathways.
- Loop recorder patients often rely more heavily on remote transmission, because the device records intermittently and the useful data is the infrequent event. Ask how episodes are transmitted and who reviews them.
- Remote monitoring does not replace all in-person checks. Expect some appointments to remain in clinic for device interrogation, wound or pocket review, and reprogramming.
A useful next step
Before enrolling, ask three concrete questions: which of your specific devices are compatible, how often transmissions are expected, and who contacts you — and how quickly — if an alert is triggered. For general background on device remote monitoring, the major device manufacturers and professional societies publish patient guides; for example, Heart Rhythm Society offers patient-oriented material on arrhythmia devices and follow-up.
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