Sestre milosrdnice University Hospital Center performs around a hundred cardiac arrhythmia ablations in children annually, and doctors from developed European countries come to Vinogradska for training.
The Sestre milosrdnice University Hospital Center is the only hospital in Croatia and among the few in the region that regularly performs cardiac arrhythmia ablations in the pediatric population. This minimally invasive procedure precisely destroys the diseased heart tissue causing the arrhythmia, which is why children from other countries come for treatment.
Associate Professor Vjekoslav Radeljić, MD, PhD, who heads the Department of Invasive and Interventional Cardiology at the Clinic for Heart and Vascular Diseases, spoke to 24sata about the technique and advances in invasive cardiology. He particularly emphasized the satisfaction with the collaboration with pediatricians, including Assistant Professor Nikola Krmek, MD, PhD, and Hrvoje Kniewald, MD, with whom cardiologists jointly treat children.
Annually, the institution performs about 100 arrhythmia ablations in children, in addition to 400 ablations in adult patients. "The Sestre milosrdnice University Hospital Center is the reference center for cardiac arrhythmia ablations of the Ministry of Health of the Republic of Croatia, and that is our duty," emphasized Professor Radeljić.
Arrhythmia manifests as a sudden increase in pulse from a normal 80 beats per minute to 200 or more, accompanied by malaise, dizziness, or loss of consciousness. In young children, parents notice a sudden change in behavior.
"If it's a young child, parents notice that the child suddenly changes. They stop playing, appear exhausted and listless. It's as if someone 'unplugged them.' The pulse rises to over 200 beats per minute, and blood pressure drops suddenly," described Professor Radeljić.
Treatment is carried out through ablation, a minimally invasive procedure in which the heart is accessed through a vein in the groin or neck. Special computerized mapping systems determine the exact site of the arrhythmia, which is then removed using radiofrequency energy or cryoablation, i.e., freezing. "This way, we eliminate the cause of the disease," he explained.
The results of the procedure are exceptionally good. "More than 90% of children never have arrhythmia again after the procedure. This is a significant difference compared to treatment with medication because here, with ablation, we don't control the disease; we cure it. Patients return to normal life, sports, and other daily activities as if the disease never existed," said Professor Radeljić.
Such a procedure requires special expertise and training. In addition to pediatric and interventional cardiologists, anesthesiologists, nurses, engineers, and cardiac mapping specialists are involved.
In recent years, Croatian interventional cardiology has made a significant leap and is now comparable to the most developed European countries. "All our doctors are trained not only within our institution but also in various European centers with which we collaborate. For the past ten or more years, we have had doctors from developed European countries coming to Vinogradska for training. Recently, doctors from Norway were here for training on new pacemakers with Dr. Đula, and before them, Danes and others," revealed Professor Radeljić.
He also touched on frequent misconceptions about Croatian healthcare. "For example, for cardiac arrhythmia ablation, patients in some European countries wait one to one and a half years. Here, the procedure is usually performed within a few months," he added.
He was particularly surprised by the experience from the UK. "There, I encountered a different system that suffers from a shortage of staff. During an afternoon procedure under general anesthesia, I asked my mentor at 5 PM whether they would keep the patient overnight for monitoring. He replied that the patient would go home the same evening around 10 PM because they don't have enough nurses. Here, after such a procedure, the patient stays under observation for at least 24 hours. Nurses monitor for bleeding or other complications. That's a significant safety difference," he recounted.
The Sestre milosrdnice University Hospital Center today has technology that enables almost all modern cardiology procedures. "From cardiac arrhythmia ablations to the most complex heart valve procedures without classic surgery, we do all of this at Vinogradska today. The hospital treats about 800 patients with acute myocardial infarction annually, which is the most in Croatia. We cover a large area and are part of the national network for emergency heart attack care, which was founded by our mentors from Vinogradska. On average, we treat two heart attack patients every day," stated Professor Radeljić.
The latest methods for treating heart valve diseases have also been introduced. "In addition to TAVI procedures, we also implant special clips on leaking heart valves. This is technology developed by leading global companies, and some devices are expensive, so we are fortunate to be able to use them. Each procedure requires detailed planning. Based on CT and ultrasound, we determine the exact shape and size of the device for each patient. Such personalization is key to treatment success," explained the cardiologist from Sestre milosrdnice, adding: "We have an excellent cardiac ultrasound team that serves as our eyes inside the patient's heart, providing invaluable data for treatment."
Professor Radeljić is particularly proud that today almost all complex cardiology procedures can be performed in Croatia. "In the last six to seven years, we have implemented practically everything that exists in modern interventional cardiology for children and adults. We have no need to send patients abroad. We can do everything here, in our hospital," he emphasized.
Behind all the technologies and procedures, he points out, are people. "We get up in the middle of the night, leave our families, and come to save lives. People often know their hairdresser's name, but not the name of the doctor who saved their life at three in the morning and implanted a stent. It's incredible, but that's how it is," he said with a laugh.
That modern cardiology truly changes lives is confirmed by patients. "My pulse wasn't right; I was losing consciousness and feeling exhausted. I came to the hospital in the morning, the procedure was done very quickly, and after waking up, I felt great," said a patient who had serious heart valve problems for years.
