AFIC/NIHD- Electrophysiology

Introduction

The Electrophysiology Department at the Armed Forces Institute of Cardiology (AFIC) has been a pioneer in cardiac electrophysiology in Pakistan. Established in 2001, the department has continually expanded its services, with early contributions from Dr. Syed Muhammad Imran Majeed, the pioneer of electrophysiology in the region. Initially focused on basic cardiac diagnostics, it soon grew to encompass advanced electrophysiological studies and catheter ablations.

AFIC & NIHD is now the national center for laser lead extraction and one of the leading institutions for arrhythmia management in Pakistan. Through a commitment to clinical excellence, cutting-edge research, and comprehensive training, the department continues to play a pivotal role in shaping the future of cardiac care in the region.

Mission and Expertise

Providing advanced diagnosis and treatment for heart rhythm disorders including atrial fibrillation, VT, WPW, and more.
Leading research in electrophysiology with a focus on innovative procedures and the future of arrhythmia management.
Offering comprehensive care through a multidisciplinary team of specialists in cardiology and electrophysiology.
Pioneering in the use of 3D mapping technologies, cryoablation, and advanced electrophysiological studies.

Consultants

Routine Procedures

The Electrophysiology Department at AFIC provides comprehensive inpatient and outpatient management for a wide range of arrhythmias and heart rhythm disorders, utilizing cutting-edge techniques and technology.

Indoor Services

Electrophysiology Studies (EPS): Diagnostic tests to evaluate the electrical activity of the heart, identify arrhythmias, and guide treatment.
Implantable Loop Recorder (ILR) Insertion: A small device implanted under the skin to monitor heart rhythms over an extended period to diagnose infrequent arrhythmias.
Catheter Ablation For SVT/WPW Syndrome/Atrial flutter: A minimally invasive procedure used to treat arrhythmias by destroying abnormal electrical pathways in the heart.
Ablation for complex arrhythmias with use of 3-D mapping systems (CARTO, Rhythmia, Precision): Advanced mapping and ablation for complex arrhythmias.
Atrial Fibrillation (AF) ablation with cryoballoon ablation system: Specialized treatment for atrial fibrillation using cryoballoon technology.
Arrhythmia Mapping and Ablation for Atrial Fibrillation (AF): A specialized procedure using advanced mapping systems to guide the ablation of abnormal heart tissue causing AF.
Pacemaker and Implantable Cardioverter-Defibrillator (ICD) Implants: Implantation of devices to regulate heart rhythm and prevent life-threatening arrhythmias.
Biventricular Pacing/CRT/LBBAP: Therapy to improve heart efficiency and synchronize its pumping function in heart failure patients.
Lead Extraction: Removal of faulty or infected pacemaker leads with precision and care.

Outdoor Services & Patient Support

Pre-procedure Consultations & Evaluations: Thorough assessments conducted by electrophysiology specialists to determine the most appropriate treatment options.
Holter monitoring / Ambulatory ECG monitoring (24 or 48-hour): Continuous monitoring of heart rhythms for diagnostic purposes.
Head-up-tilt-test (HUTT): A diagnostic test used to evaluate the cause of unexplained fainting and dizziness.
Signal-Averaged-ECG (SAECG): A non-invasive test that assesses the electrical activity of the heart.
Ambulatory BP monitoring: Continuous blood pressure monitoring over a set period.
Monitoring of implanted devices: Advanced technology for monitoring pacemakers and defibrillators, ensuring ongoing care and intervention as needed.
Patient Education: Guidance on managing heart rhythm disorders, including tailored lifestyle changes, diet, and exercise recommendations.
Follow-up Care: Comprehensive post-procedure care to monitor progress and manage any potential complications.

Research Contributions

Our department is committed to advancing the field of cardiology with groundbreaking research and evidence-based protocols.

Shiram SA, Shabbir M, Rehman WU, Ali J, Virk MA, Mehreen S, Ahmed I, Imtiaz A, Azad N, Chaudry AA. Spectrum of Cardiac Arrhythmias During Initial 48 Hours of Acute Myocardial Infarction Patients and their Association with In-Hospital Outcome. Pakistan Armed Forces Medical Journal. 2022 Nov 21;72(SUPPL-3):S428-33
Rauf MA, Hayat A, Shabbir M, Siddiqa A, Parveen S. Duration of Head Up Tilt Test for Evaluation of Vasovagal Syncope. Pakistan Armed Forces Medical Journal. 2019 Nov 29;69(Suppl-3):S375-78
Rauf MA, Kalla M, Leyva F. Successful Catheter Ablation of Ventricular Tachycardia Precipitated by Cardiac Resynchronization Therapy. The Journal of Innovations in Cardiac Rhythm Management. 2023 Mar;14(3):5379
Ali F, Rasul I, Fazal S, Hayat A, Masood N, Shah A, Hassan A, Ali G, Munir U. An Innovative Approach for the Prediction of Future Arrhythmia through T-wave Alternans on Surface Electrocardiogram (ECG). Pakistan Armed Forces Medical Journal. 2023 Dec 31;73(6):1569
Tariq MN, Samore NA, Rashid MH, Aziz S, Chaudhery G, Ali J, Azad N, Noeman A, Bukhari SN, Chaudhry AA. Frequency of Cardiac Arrhythmias in Hypertensive Patients. Pakistan Armed Forces Medical Journal. 2022 Nov 22;72(SUPPL-3):S477-81
Khan QH, Asad M, Baloch W, Naseem MM, Shabbir M, Hayat A. Evaluation of Orthostatic Hypotension by Using HUTT. Pakistan Armed Forces Medical Journal. 2020;70(Suppl-4):S737-40

Conferences and Workshops

Enhancing knowledge and expertise in electrophysiology and ECG interpretation.

RHYTHM FOR LIFE

The annual cardiac electrophysiology conference hosted by AFIC & NIHD Electrophysiology department for the last 20 years, offering learning opportunities for doctors interested in arrhythmia management.

ECG in Medical Emergencies

A one-day annual ECG workshop for junior doctors to enhance their ECG interpretation skills.

ECG Classes

A weekly ECG class aimed at cardiology fellows, held every Monday morning from 8:30 am to 9:30 am.

EP/Device Tracings

A 30-minute session for EP fellows held daily on working days from 8:00 am to 8:30 am.

Mock Sessions

Regular mock sessions held especially before the national exams for cardiology and electrophysiology exams.

Historic Milestones

Key achievements and developments in the Electrophysiology Department.

First EP procedure (2001)
First ICD implant (2001)
Introduction of EP 3D Mapping (2005)
First CRT D (2007)
First AF ablation (2019)
First laser lead extraction (2019)

Armed Forces Institute of Cardiology / National Institute of Heart Diseases

Cardiac Electrophysiology Department