Cuenca Expats Magazine, Issue 45

Photos Courtesy of CIMA

Leading the Fight Against Arrhythmias in Ecuador

Cardiovascular diseases continue to be a global health challenge, claiming the top spot as the leading cause of illness and death. Cardiac arrhythmias, accounting for almost half of these cases, represent a significant health concern. Regrettably, Ecuador had yet to witness a corresponding surge in specialized facilities dedicated to addressing cardiac arrhythmias.

Recognizing this gap and driven by a steadfast commitment to alter this national narrative, the Comprehensive Center for Pacemakers and Cardiac Arrhythmias at Monte Sinai Hospital, known as CIMA SINAI, emerged in Cuenca in March 2023.

Addressing the Gap: The absence of a dedicated center for cardiac arrhythmias in the country spurred the establishment of CIMA SINAI.

In contrast to the global trend of industrial and hospital development to combat cardiac arrhythmias, Ecuador had not reflected this progress until now. CIMA SINAI represents the first specialized center in the country devoted to the comprehensive treatment of cardiac arrhythmias.


CIMA SINAI’s Inauguration: Since March 2023, CIMA SINAI has been operational in Cuenca, positioning itself as the first specialized center for cardiac arrhythmias and pacemakers in Ecuador. The primary objective of CIMA-SINAI is to provide timely and comprehensive management of all types of cardiac arrhythmias, from prevention to definitive treatment. Equipped with state-of-the-art international technology, including the nation’s inaugural and sole Invasive Electrophysiology Lab, CIMA-SINAI ensures secure and efficient procedures such as ablations or pacemaker implants.

Infrastructure Overview: CIMA-SINAI is situated in the main tower of Monte Sinai Hospital: Tower 1, which is strategically placed adjacent to modern operating rooms, the Intensive Care Unit, and the hospital’s Emergency Department. This prime location enables the center to conduct both invasive and non-invasive procedures with the necessary agility, efficiency, and, most importantly, safety.

 Structurally and functionally, CIMA SINAI is divided into five units:

1. Clinical Unit for Cardiac Stimulation and Pacemakers:

  • Home to the country’s first and only Invasive Electrophysiology Lab, designed exclusively for the definitive treatment of cardiac arrhythmias.

2. Clinical Unit for Cardiac Stimulation and Pacemakers:

  • Specialized in the placement and management of pacemakers.

3. Holter and Remote Monitoring Unit:

  • Focused on long-term electrocardiographic monitoring using external Holter monitors for 24-hour observations and subcutaneously implanted monitors for up to two years.

4. Syncope and Complementary Methods Unit:

  • The first and only unit in the country dedicated to diagnosing and treating fainting episodes, utilizing methods such as the tilt table test and continuous monitoring through implantable loop recorders.

5. Clinical Arrhythmias Unit:

  • Equipped with three clinical consultation rooms, ensuring accurate electrocardiographic analysis. 

Human Team at CIMA-SINAI: CIMA SINAI distinguishes itself by maintaining a complete team of seven cardio electrophysiologists ensuring a high success rate and minimal complications. In addition to providing comprehensive care, the team includes clinical cardiologists, echocardiologists, internists, nutritionists, and psychologists. All staff undergo training in the management of cardiac emergencies through official courses from the American Heart Association (AHA).

CIMA SINAI’s commitment to holistic patient care is further exemplified by the inclusion of a clinical cardiologist, two echocardiologists, an internist, a nutritionist, and a psychologist. The collaborative efforts of the medical, nursing, and administrative staff—all trained in the management of cardiac emergencies—ensure a well-rounded approach to patient care.

Mission and Vision of CIMA-SINAI:

Mission: To provide comprehensive and subspecialized medical care through a team of individuals for whom ethics and solidarity are primary values. The mission is to seek timely management of all types of cardiac arrhythmias, from prevention to definitive treatment.

Vision: To achieve leadership and become the national and international reference site for addressing and treating cardiac arrhythmias, relying on qualified personnel to meet the needs of our users


CIMA-SINAI’s Academic/Scientific Commitment: Monte Sinai Hospital, serving as an AHA Training Center, aligns with CIMA-SINAI’s commitment to training in cardiovascular emergencies and CPR. This commitment contributes significantly to the “Cuenca Cardioprotected City” program, initiated in 2021 by Dr. Diego Serrano, founder of CIMA-SINAI and then-ex-president of the Sociedad Ecuatoriana de Cardiología.

Prehospital Care at CIMA-SINAI: Recognizing the critical importance of prompt attention to cardiovascular pathologies, especially cardiac arrhythmias, CIMA-SINAI operates a 24/7 ambulance service. The ambulance is equipped with electrocardiography and a cardiac laboratory, ensuring early treatment and preventing complications. The medical and paramedical staff of the CIMA-SINAI ambulance, in addition to being trained for these treatments, are mostly instructors in cardiovascular emergency training courses. This extensive training instills confidence and ensures the highest level of care, both locally and nationally.

Community Partnerships: In its first year of operation, CIMA-SINAI forged partnerships with institutions that share its ethical and solidary philosophy. Key collaborators include the Humanitarian Hospital Pablo Jaramillo Foundation, Social Vision Foundation, and the Physio-Gym Physical Rehabilitation Center.

These collaborations, along with contributions from individuals and doctors across the country, enabled the treatment of patients with limited resources.

CIMA-SINAI’s commitment to the community extends to its contribution to the “Cuenca Cardioprotected City” program. Through the training of both medical and non-medical personnel in cardiovascular emergencies and CPR, the center actively participates in building a cardioprotected environment within the city. Additionally, CIMA-SINAI has recently signed a partnership agreement with Social Vision, a local community charity dedicated to aiding Cuenca’s medically vulnerable, in collaboration with Asistencia en Emergencias Médicas (ASSISTEM)


CIMA SINAI’s First Year: Since its foundation, CIMA SINAI has attended to 3148 patients, conducting 1273 non-invasive procedures and 116 invasive procedures with excellent results and zero complications. This track record underscores the center’s dedication to providing high-quality care while minimizing potential risks associated with complex procedures.In essence, CIMA-SINAÍ stands as a beacon of hope, revolutionizing cardiac care in Ecuador and paving the way towards a future where cardiac arrhythmias are met with the expertise and resources they demand, sparing countless lives from the clutches of this formidable ailment. Cuenca expats are fortunate to have this world-class cardo center near them.


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