Patient care— Heart and Lungs Center— Electrophysiology
Heart and Lungs Center
Hart Long Centrum

Electrophysiology

Leiden University Medical Center’s arrhythmia section is active in all aspects of the care of children, adolescents, and adult patients with cardiac arrhythmias. Specialized out-patient clinics are organized for the care of patients with electrical devices and pediatric patients. Invasive procedures are performed in any of the three state-of-art LUMC catheterization laboratories.

Neuro-humoral assessment equipment is available. All current 3-dimensional mapping and ablation systems are available and allow us to treat complex and life threatening arrhythmias.

The arrhythmia section has over 12 years’ experience with diagnosing and treating patients with cardiac arrhythmias. New pioneering techniques have been introduced to treat patients with atrial fibrillation or ventricular arrhythmias. Furthermore treating end-stage heart failure patients with resynchronization therapy is an important and challenging clinical task.

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Neuro-humoral assessment equipment is available. All current 3-dimensional mapping and ablation systems are available and allow us to treat complex and life threatening arrhythmias.

The arrhythmia section has over 12 years’ experience with diagnosing and treating patients with cardiac arrhythmias. New pioneering techniques have been introduced to treat patients with atrial fibrillation or ventricular arrhythmias. Furthermore treating end-stage heart failure patients with resynchronization therapy is an important and challenging clinical task.

With more than 400 catheter ablation procedures, over 450 defibrillator implants, 180 resynchronization devices, and more than 60 surgical interventions (together with the department of thoracic surgery, Prof. R.A.E. Dion) in 2005 Leiden University Medical Center is one of the largest centres in Europe.

Research

The focus of the clinical arrhythmia unit is shifting towards more basic topics. Together with Prof. A.C. Gittenberger-de Groot (department of Anatomy) and Prof. A. van der Laarse (laboratory of Experimental Cardiology) rsearch has started to reveal the clinical importance of the development of the conduction system. A new state of the art mapping system, installed in 2003, allows high density mapping studies of cell cultures and facilitates the stem-cell research program (together with D.E. Atsma, MD).

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Research

The focus of the clinical arrhythmia unit is shifting towards more basic topics. Together with Prof. A.C. Gittenberger-de Groot (department of Anatomy) and Prof. A. van der Laarse (laboratory of Experimental Cardiology) rsearch has started to reveal the clinical importance of the development of the conduction system. A new state of the art mapping system, installed in 2003, allows high density mapping studies of cell cultures and facilitates the stem-cell research program (together with D.E. Atsma, MD).

Image fusion is another essential line of research. Together with the department of Radiology (Prof. A. de Roos, MD) and J.J.Bax, MD (director of cardiac imaging) studies are performed to integrate CT/MRI and Intra-cardiac echo with 3-dimensional mapping systems to facilitate complex catheter ablation procedures. In the near future we expect to open an integrated MRI/cathlab facility.

Tissue Doppler imaging studies (together with J.J. Bax, MD) in patients with end-stage heart failure will result in improved selection criteria for resynchronization therapy candidates and in optimalization of the post implant status of the patients.

New 3-D mapping techniques are applied to facilitate treatment of patients with rapid ventricular tachycardia and atrial fibrillation.

Patients with congenital heart disease and supra-ventricular arrhythmias represent an important clinical problem. Three dimensional mapping tools have been developed to improve the results of catheter ablation procedures in this group of patients.

Clinical trials

4-Site Study
Simple Study
Painfree Study
Euro Eco Study
EFFECT Study

4-Site Study

The purpose of this study is to evaluate and document appropriate clinical performance of the new 4-Site header/lead interface in the TELIGEN 100 HE 4-site (VR and DR) implantable cardioverter defibrillator (ICD) PGs (Models F103; F111), COGNIS 100 HE 4-site cardiac resynchronization therapy ICD (CRT-D) PG (Model P108) when connected to any of the RELIANCE Quadripolar  (4-site) defribrillation leads.

Simple Study

The primary objective of this study is to determine if  defibrillation testing (DT) can be eliminated as a component of  ICD implantation, while still maintaining the clinical effetiveness of ICD`s.

The secondary objective of this trial is evaluation of the peri-operative safety of defibrillation testing.

Painfree Study

The purpose of the PainFree SST Clinical Study is to evaluate the rate of inappropriate shocks at one year post implant in subjects implanted with a Protecta CRT-D/DR/VR device.

Euro Eco Study

This trial aims to assess the economic effects of ‘Home Monitoring’ technology versus classical follow-up of  ICD patients from two perspectives:

  • the cost-effectiveness for the payer of health care;
  • the economic impact on the physician, hospital and patient.

Patient follow-up will be managed according to a pre-defined algorithm based on previous trial data aiming at reducing in-hospital visits as much as possible while retaining maximal effectiveness and safety.

EFFECT Study

Clinical effect of heart failure management via Home Monitoring with a focus on Atrial Fibrillation.

Aim of the study:

  • Study arm A: Interindividual comparison of management of AF and early optimization of CRT via Home Monitoring vs. standard patient management regarding a clinical composite endpoint within an observation period of 12 months.
  • Study arm B: Detection of AF episodes during the first month of CRT for the evaluation of the eligibility to participate in study arm A or evaluation of AF occurrence during CRT if no AF is detected during the one month evaluation phase.

Relevant departments

Radiology