Unitat d'Arrítmies i Estimulació Cardíaca

Website of the Team of Professionals of the Heart Institute of Germans Trias i Pujol

Electrophysiology and Arrhythmias Unit

The Arrhythmia and Cardiac Pacing Unit of the Germans Trias i Pujol University Hospital was created in 2010, although its activity dates back decades: the hospital was a pioneer in Catalonia in the implantation of pacemakers by cardiologists, an activity that began in 1988 and has been consolidated with almost 40 years of experience. In 2003, the Unit incorporated the first electrophysiology procedures and the implantation of automatic defibrillators and cardiac resynchronization devices.

Currently, the Unit offers a comprehensive approach to bradyarrhythmias and tachyarrhythmias, with a complete circuit that includes:

Specialized external consultations.
On-site and remote monitoring of all devices.
Short and long-term Holter studies, subcutaneous Holters
Functional tests and stratification of the risk of sudden death
Implantation and monitoring of state-of-the-art devices: leadless, S-ICD, ILR, physiological stimulation (His and LBBAP).
Ablation of all substrates with radiofrequency, cryoablation, PFA, dual (RF/PFA), three-dimensional navigation systems, image integration and intracardiac echocardiography.

Annual volume of activity (average values 2022–2024)

Total ablations: 280–360/year
- AF / atypical flutter: 130–165
- Typical Flutter: 65–90
- SVT (TIN/NAV/VA/TA): 70–110
- TV + EV: 20–35
Diagnostic studies: 40–50/year
Pharmacological tests: 10–25/year
Pacemaker implants: 330–400/year
Spare parts: 95–110/year
DAI (mono + S-ICD): 50–70 primoimplants/year
CRT (P + D): 10–20 primoimplants/year
ILR (implant/explant): 30–40/year
Electrode removal: 10–16/year
Cardioversions: 85–105/year

Recent years have been marked by significant technological expansion:

Pulsed Field Ablation (PFA) as a first-line technology for FA.
Affera Sphere-9 with combined mapping and ablation capability.
New generation leadless systems (Aveir DR)
EV-ICD as an alternative to transvenous ICDs.
Progressive expansion of physiological stimulation of the conduction system (His + LBBAP).
Frequent implantation of S-ICD devices and integration into remote monitoring programs.

Electrode extraction

The electrode extraction program began in April 1993 with simple traction of an infected DDD system. Since then, the Unit has evolved towards modern techniques and high-safety protocols.

Currently, the program routinely uses:

Mechanical extraction sheaths, which allow controlled and progressive advancement over the cable to be removed.
Cook’s femoral loops for distal capture when superior traction is insufficient, providing a safe and effective alternative route.
Multidisciplinary planning with anesthesia, cardiac surgery and ICU for complex cases.
Specific hemodynamic preparation and monitoring circuit.

Facilities

Room I
Operational since 2011 , equipped with General Electrics OEC 9900 Elite , for implants and simple procedures.

Room II
Opened in 2011 and completely renovated in December 2024. Includes:

GE ALLIA IGS 530 PULSE interventional radiology system.
Main screen GE Medical-Grade Large Display Monitor (8 MP) integrated into the Allia platform.
3D navigation systems:
- CARTO® 3 and CARTO-Sound
- EnSite NavX™ Velocity
- Affera Browser
Complete cryoablation system.
Multi-brand programmer tower.
Integration with intracardiac echocardiography and advanced imaging

Day hospital
Annexed to the Hemodynamics and Electrophysiology rooms, the Day Hospital is used by both Units and is directly connected to the Coronary Unit.
Equipped with 6 beds, it facilitates the performance of outpatient procedures.

Device tracking queries
Two queries equipped with the necessary programmers.

Human team

Specialist electrophysiologists: 5
Specialized nursing in EP and remote monitoring: 6–8
Remote monitoring unit: nursing + administrative management
Direct collaboration with anesthesia, coronary, hemodynamics and cardiac surgery.

Training, teaching and courses

The Unit has an outstanding teaching activity, both in internal and external training.

Courses and programs taught at HUGTiP / iCor

Physiological Stimulation of the Conduction System Course (His and LBBAP)
Practical workshop on Ventricular Tachycardia Ablation with Intracardiac Echocardiography (ICE)
Epicardial Ablation Course
Marshall Vein Alcoholization Course (VOM) in persistent AF
Transseptal Puncture Course
Remote Monitoring and Comprehensive Device Management Course. Aimed especially at nurses and technicians.

Other outstanding teaching activities

Training of electrophysiology fellows
Cardiology resident training
Participation as guest lecturers in SEC-Ritmo, ESC/EHRA courses
Cardiology Service Continuing Education Sessions.
Monthly internal teaching sessions with review of cases and protocols.

Scientific research and production

Research lines:

Atrial and ventricular arrhythmic substrate
– Fibrosis, advanced mapping, MRI and local impedance in FA and TV.
Ablation and new technologies
– PFA, Affera, cryo, CARTO/EnSite, Carto-Sound and Marshall ablation.
Physiological stimulation and devices
– His/LBBAP, CRT, S-ICD, SEC records and advanced programming studies.
Experimental models and image
– Porcine models of infarction, cardiac remodeling and histological correlation.
Remote monitoring and clinical risk
– Sleep apnea, prediction of AF recurrence and flow optimization.

Scientific production:

>80 publications in high-impact journals (NEJM, JACC-EP, Europace, Heart Rhythm, Circ EP, REC…).
>100 communications and continuous participation in HRS, EHRA, ESC and Ritmo.
Several SEC-Ritmo awards and competitive scholarships.
Participation in multiple clinical trials and translational projects.

Medical Team

Roger Villuendas Sabaté

Felipe Bisbal Van-Bylen

Staff physician

Javier Cantalapiedra Romero

Staff physician

Axel Sarrias Mercè

Staff physician

Nursing

Ramon Mata López

Nurses Supervisor

Estela Andrés Sánchez

Nurse

Elena Bernabéu Casares

Nurse

Carmen Cuenca Cabrero

Nurse

Asier Jaume Molinero Ochoa

Nurse

Verónica Montero Dávila

Nurse

Idoia Murua Lario

Nurse

Marta Riera Musach

Nurse

Research nurses

Coordinators

Postdoctoral researchers

Predoctoral researchers

Laboratory technicians

Image technician

Resident Doctors R5

Resident Doctors R4

Resident Doctors R3

Resident Doctors R2

Resident Doctors R1

Former Resident Doctors

Cardiology Residents

Residence 2020-2025
• Dr. Andrea Carrete Barca
• Dr. Cristina Ferrero Molina
• Dr. Eugeniu Grama

Residence 2019-2024
• Dr. Helena Lopez Martinez
• Dr. Elena de Oliveira Cañedo

Residence 2018-2023
• Dr. Claudia Escabia Riera
• Dr. Daniel Casquete Sánchez
• Dr. Cristina Pérez Montoliu

Residence 2017-2022
• Dr. Joan Francesc Andrés Cordón
• Dr. Andrea Borrellas Martin
• Dr. Helena Resta Saurí

Residency 2016-2021
• Dr. Marta González Lopera
• Dr. Borja Ruiz Martinez
• Dr. Elena Seder Colomina

Residency 2015-2020
• Dr. Julia Aranyó Llach
• Dr. Edgar Fadeuilhe Grau
• Dr. Mª José Martínez Membrive

Residency 2014-2019
• Dr. Raquel Adeliño Recasens
• Dr. Enric Cascos Garcia
• Dr. Nina Soto Flores

Residence 2013-2018:
• Dr. Marc Abulí Lluch
• Dr. Nabil El Ouaddi
• Dr. Victoria Vilalta del Olmo

Residence 2012-2017:
• Dr. Oriol De Diego Soler
• Dr. Beatriz Toledano León
• Dr. Xavi Armario Bel

Residence 2011-2016:
• Dr. Elena Georgieva Elchinova
• Dr. Carles Díez López
• Dr. Marc Ferrer Massot

Residence 2010-2015:
• Dr. Teresa Giralt Borrell
• Dr. Josep Mª Viguer Ribó

Residence 2009-2014:
• Dr. Raquel Pla Rovira
• Dr. Irene Santos Pardo
• Dr. Gladys Juncà Puig

Residence 2008-2013:
• Dr. Elena Gómez Denia
• Dr. Carlos Labata Salvador
• Dr. Teresa Oliveras Vila

Residence 2007-2012:
• Dr. Miquel Espriu Simon
• Dr. Carlos Garcia Alonso
• Dr. Ángel Caballero Parrilla

Residence 2006-2011:
• Dr. Meritxell Lloreda Surribas
• Dr. Ángeles González Guardia
• Dr. Xavier Aparicio Ortiz

Residence 2005-2010:
• Dr. Silvia Masmitjà Comajuan
• Dr. Núria Ribas Barquet
• Dr. Mireia Andrés Villareal

Residence 2004-2009:
• Dr. Carolina Bosch Carabante
• Dr. Xavier Carrillo Suarez

Residence 2003-2008:
• Dr. Silvia Montserrat Ortego
• Dr. Albert Teis Soley

Residence 2002-2007:
• Dr. Neus Salvatella Giralt
• Dr. Elisabet Zamora Serrallonga

Residence 2001-2006
• Dr. Antoni Carol Ruiz
• Dr. Elena Tizón Marcos

Residence 2000-2005
• Dr. Eva Bernal Labrador
• Dr. Eduard Claver Garrido

Residence 1999-2004
• Dr. Roger Villuendas Sabaté
• Dr. Cosme Garcia Garcia

Residence 1998-2003
• Dr. Oriol Rodríguez Leor
• Dr. Miquel Gómez Pérez

Residence 1997-2001
• Dr. Xavier Fosch Mur

Residence 1996-2000
• Dr. Silvia Serrano García
• Dr. Jose Manuel Forcada Sainz

Residence 1995-1998
• Dr. Roman Freixa Pamias

Residence 1994-1998
• Dr. Mohammad Ali Dbouk
• Dr. Laura Guillamon Torán

Cardiac Surgery Residents

Residence 2020-2025
• Dr. Danela Figuereo Beltre

Residency 2016-2021
• Dr. Anna Llorens Ferrer

Residence 2010-2015
• Dr. Juan Flores Siguenza

* Active professional at the Heart Institute (iCor)

Administrative Support

Carlos Calzado Flores

Administrative

Healthcare, teaching and research areas
iCor research

The team includes cardiologists, cardiac surgeons, residents, nurses, assistants, administatives, researchers from multidisciplinary backgrounds and other specialties