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The Center for Atrial Fibrillation and Electrophysiology at HCA

Hunterdon Cardiovascular Associates (HCA) has established The Center for Atrial Fibrillation and Electrophysiology to bring the best of both cutting-edge technology and personalized care to you. The center provides state-of-the-art arrhythmia diagnosis and treatment, with an emphasis on making important decisions with you, rather than for you. We offer a full range of arrhythmia services, including:

Personalized consultation
Ambulatory cardiac monitoring
Loop recorder implantation and interpretation
Pacemaker and defibrillator implantation and clinic
Specialty atrial fibrillation (AFib) management
Cardiac electrophysiology testing
Cardiac ablation
WATCHMAN procedure

Contact us today at 908-806-0180 or by filling out the contact form.

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The risk of AFib increases with age, and many people with AFib have some form of underlying heart problem. Common causes of AFib include:

Hypertension, particularly longstanding
Prior heart attack
Congestive heart failure
Heart valve problems, such as mitral regurgitation or mitral stenosis
Major surgery, especially heart surgery
Alcohol use, including intermittent heavy (“binge”) drinking
Hyperthyroidism: AFib occurs in about 15 percent of all people with an overactive thyroid gland

Medications: some medications can precipitate AFib as a side effect
Obstructive sleep apnea
Most chronic lung diseases, particularly emphysema
Obesity
Physical inactivity
Diabetes
Chronic kidney disease

What Happens During AFib

Normally, your heart contracts and relaxes with a regular rhythm. In AFib, the upper chambers of the heart (the atria) activate chaotically. This disorganization stops the atria from pumping normally. When this happens, it significantly increases the risk that a blood clot will form in the left atrium. If a clot forms and becomes dislodged, it can be carried through the bloodstream to the brain, where it may lodge in an artery, blocking the flow of blood, and resulting in a stroke. About 15-20 percent of strokes are caused by AFib. To help prevent a stroke, most people with AFib are prescribed an anticoagulant, also known as a blood thinner.

AFib can also lead to symptoms including:

Heart racing or skipping beats
Chest tightness or pain
Dizziness or lightheadedness
Difficulty catching one’s breath
Palpitations
Fatigue
Weakness
Heart failure
Angina
Or no symptoms at all

Treatments

Electrical cardioversion

While under anesthesia, pads are placed on the chest to deliver an electric current that resets your heart rhythm. Some people with newly diagnosed AFib may have the option to undergo pharmacologic cardioversion, in which a medication is used to restore the normal heart rhythm.

Medications

Many medications can be used to help treat different aspects of AFib. Our expert team will help you understand your medications and answer all of your questions.

Pacemaker implantation

Pacemakers are electronic devices that prevent the heartbeat from becoming too slow. Some people with AFib have periods of slow heart rates for which a pacemaker is needed. Ablation can be used in conjunction with pacemaker implantation in some people with AFib that does not respond to either treatment alone.

Cardiac ablation

Ablation is a medical procedure that offers the best chance at maintaining a normal heart rhythm for patients with AFib. Thermal energy, either heat (radiofrequency ablation) or cold (cryoablation) is applied to the area of the heart responsible for initiating or maintaining AFib. Cardiac ablation is most effective for people with an early form of the condition (paroxysmal AFib), but may still provide benefit for those with more advanced (persistent) AFib. This is especially true for those patients who want to take fewer long-term medications.

Other Types of Arrhythmias Treated

AFib is just one kind of arrhythmia—a supraventricular arrhythmia. The Center for Atrial Fibrillation and Electrophysiology treats many other arrhythmias besides AFib. Other arrhythmias treated include:

Tachycardia: heart rhythm of more than 100 beats per minute
Bradycardia: heart rhythm below 60 beats per minute
Bradyarrhythmias: slow heart rhythms caused by disease in the heart’s conduction system
Supraventricular arrhythmias: begin in the upper (supra) chambers of the heart (the atria)
Atrial flutter: similar to AFib, but less chaotic beating
Wolff-Parkinson-White syndrome (WPW): congenital disorder; an extra electrical pathway between heart’s upper and lower chambers causes rapid heartbeat; rare

Ventricular arrhythmias: begin in the lower chambers of the heart (the ventricles)
- Brugada syndrome: genetic disorder; causes a dangerous irregular heartbeat; can result in cardiac arrest
- Ventricular tachycardia: three or more heartbeats in a row at a rate of more than 100 beats per minute
- Long QT syndrome (LQTS): can cause fast, chaotic heartbeats; acquired or congenital; often misdiagnosed as seizure disorder

Our Team

Our innovative center and its team is dedicated to treating disorders of the heart’s electrical system, working with patients to determine the best treatment options for their unique needs. Dr. Rudnick and Dr. Tiwari bring specialized expertise to the treatment of heart rhythm disorders and are both board certified in the management of these conditions. Laurie Marinaro Pascale, APN-C, brings many years of experience in inpatient acute care and critical care cardiology, as well as outpatient cardiac care. This dynamic, highly qualified team provides a comprehensive approach to diagnosing and treating people with AFib. The clinical science this team brings to managing AFib has been proven to reduce the risks of congestive heart failure, stroke, and hospital admissions in people with this condition.

Andrew RudnickMD, MS, FACC

Gautam Verma
MD

Laurie Marinaro PascaleMSN, APN-C

Meaghan BrownAPN-C, MSN

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Please note this website is NOT monitored by clinical staff. If you are experiencing any cardiac symptoms. Please call 911 or go to your nearest emergency room.