CONDITIONS WE TREAT
Heart Rhythm Disorders — Palpitations & Atrial Fibrillation
Palpitations — a racing, fluttering, or skipping heartbeat — are the most common reason people come in, and the most important rhythm to catch is atrial fibrillation (AFib). We find what's behind the symptom and treat it — and AFib's stroke risk is largely preventable. Symptoms like these can be frightening, and they're easy to brush aside — or to have brushed aside. We take them seriously and work to find the cause.
What it is
An arrhythmia is a problem with the rate or rhythm of the heartbeat, arising from the heart's electrical system. By far the most common sustained arrhythmia is atrial fibrillation (AFib) — an irregular, often rapid rhythm that raises the risk of stroke. We also evaluate slow rhythms (bradycardia), fast rhythms (tachycardia), and unexplained fainting. Most people first notice a rhythm problem as palpitations.
Symptoms — especially palpitations
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Palpitations — a racing, fluttering, pounding, or skipping heartbeat
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An irregular pulse, or one that feels unusually fast or slow
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Fainting or near-fainting (syncope), lightheadedness, or dizziness
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Shortness of breath, chest discomfort, or unusual fatigue
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Sometimes no symptoms at all — AFib can be silent and first show up as a stroke
Occasional skipped beats are common and often harmless. Palpitations that are frequent or prolonged, or that come with fainting, chest pain, or breathlessness, should be evaluated.
Why it matters
Risk factors
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Older age, high blood pressure, and coronary artery disease
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Heart failure and valve disease
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Diabetes, obesity, and obstructive sleep apnea
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Excess alcohol and thyroid disease
Diagnostic Testing
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In-house echocardiography — assesses the heart's structure and function and looks for causes such as valve disease or a weakened heart muscle
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Patch monitoring — a wearable adhesive ECG patch worn for days to weeks to capture intermittent palpitations and measure how much AFib is present
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Laboratory analysis — bloodwork including a CBC, CMP, and TSH with free T4 to check for anemia, electrolyte or kidney issues, and thyroid disease that can trigger palpitations and AFib
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ECG — to record the rhythm in the moment
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Implantable loop recorder — if patch monitoring is inconclusive and more information is needed to guide ongoing care, we can upgrade to an implantable loop recorder, a tiny under-the-skin monitor that watches the rhythm continuously for up to about three years (Loop Recorder)
Treatment options
Medical & conservative therapy
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Stroke prevention — anticoagulation when indicated, guided by the CHA₂DS₂-VASc score. Aspirin alone is not adequate protection in AFib. Medical Therapy →
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Rate or rhythm control — medications to slow the heart rate or restore and maintain a normal rhythm.
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TEE-guided cardioversion — resetting the rhythm to normal, with a transesophageal echo first to rule out clot. (Cardioversion)
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Treating the drivers — blood pressure, sleep apnea, thyroid, and alcohol.
Invasive treatment
Each device addresses a specific problem; we match the device to the diagnosis, and explain which one fits your situation and why. Cardioversion and the lead-based devices are performed in the hospital outpatient department; the loop recorder is an office-lab procedure.
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TEE-guided cardioversion — for AFib or atrial flutter, to reset the rhythm. (Cardioversion)
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Implantable loop recorder — for diagnosis and monitoring of infrequent rhythms. (Loop Recorder)
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Pacemaker — for slow heart rhythms such as bradycardia or heart block, to keep the heart rate steady.
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Implantable cardioverter-defibrillator (ICD) — for protection against dangerous fast (ventricular) rhythms and the prevention of sudden cardiac death, typically in patients with a weakened heart muscle (reduced ejection fraction) or after a life-threatening arrhythmia.
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CRT-D / CRT-P (cardiac resynchronization) — for certain congestive heart failure with a reduced ejection fraction and an electrical conduction delay, to coordinate the heart’s chambers and improve its pumping efficiency.
Electrophysiology & ablation — directed by us, performed by the right specialist
When medications or cardioversion aren't enough to control atrial fibrillation, an electrophysiology (EP) study and catheter ablation can be highly effective. We don't perform ablation in-house — instead, we select the electrophysiologist best matched to your case, coordinate the referral, and stay actively involved in your follow-up and your ongoing rhythm- and stroke-prevention plan. You remain our patient throughout.
Frequently asked questions
For referring providers — We diagnose and manage the full range of rhythm problems and offer in-house monitoring and outpatient device implantation, with same-day discharge. Refer: (918) 943-5303 · fax (855) 312-3594.
Refer urgently: syncope with suspected bradycardia, or new AF with hemodynamic instability · Routinely: paroxysmal AF for rhythm management, cryptogenic stroke for loop-recorder evaluation, or symptomatic bradycardia for pacemaker evaluation. Full referral guide →