How to establish an arrhythmia unit in the 21st century

Arrhythmia and cardiac electrophysiology services are an innovative and fast-growing branch of clinical cardiology. Initiating an arrhythmia unit involves proper selection of personnel, as well as technical, structural, and organizational requirements. Proper selection of personnel includes specialized and well-trained physicians, nurses, and medical technicians in the electrophysiology laboratories and on the hospital wards. Standard electrophysiology laboratories must support the full spectrum of catheter-based diagnosis and therapies of cardiac arrhythmias. This includes state-of-the-art fluoroscopy and 3-dimensional mapping systems used during complex procedures such as catheter ablation of atrial fibrillation or ventricular tachycardia. Furthermore, technical requirements need to support pacemaker and defibrillator implantation as one of the core tasks of a specialized arrhythmia unit. Outpatient clinics should fulfill technical capabilities to perform a diverse spectrum of pre-and postinterventional diagnostics, guaranteeing proper patient follow-up. Structural requirements should focus on close physical integration of individual functional units allowing for an effective and safe workflow. Finally, organizational requirements such as networking between arrhythmia specialists and referring physicians and hospitals are essential for patient recruitment and high-quality postdischarge patient care. Regular educational programs for physicians, nurses, and technicians are essential in such an innovative and fast-growing field of cardiology.