Our electrophysiologists collaborate with your cardiologist or primary care physician to provide comprehensive care at every stage of treatment. We follow standardized protocols to ensure high-quality, guideline-recommended care. 

Our physicians use advanced 3D mapping technology in our state-of-the-art electrophysiology labs to identify each patient’s arrhythmia type and origin. Based on this, we offer a full range of personalized treatment options, including the latest cardiac ablation or cardioversion procedures and other emerging therapies as well as less invasive procedures, tailored medications, and coaching on managing your unique risk factors.

View the Electrophysiology section of our most recent Inova Schar Heart and Vascular Outcomes Report to see our procedural volumes and how we compare against national benchmarks. 

Inova may offer virtual telemedicine appointments using live video visits, e-visits or telephone visits to patients (new or established) who are physically located at the time of the virtual visit in Virginia. Learn about your options

Areas of focus

Stroke Prevention

For patients at high risk of stroke, the American Heart Association, The American College of Cardiology and Heart Rhythm Society guidelines recommend using either blood-thinning medications or, in certain cases, a WATCHMAN procedure to reduce stroke risk.

Rate Control

Medications reduce the fast pulse most patients experience during AFib. These may include beta-blockers or calcium channel blockers. The use of these medications helps control symptoms of AFib and mitigates the risks of the heart’s pumping function weakening over time. However, in some cases, medications are ineffective in controlling the heart rate and patients may need a rhythm control approach (see below) or pacemaker implantation and AV node ablation.

Rhythm Control

For patients with their first episode of AFib or those with symptoms, the American Heart Association, The American College of Cardiology and Heart Rhythm Society guidelines recommend correcting AFib back to a normal rhythm. This can be achieved with medications (called antiarrhythmic drugs) or procedures such as a cardioversion or catheter ablation. Controversy remains about the use of rhythm control for the treatment of recurrent AFib in patients without symptoms. However, recent studies suggest rhythm control may reduce the likelihood of hospitalization, stroke, or heart attack even in asymptomatic patients.

Treatment options

Antiarrhythmic drugs (AADs) are moderately effective in reducing symptoms of AFib and improving quality of life. 

  • Generally, 45 – 55% of treated patients maintain a normal heart rhythm in the first year of treatment.*
  • Many patients do not respond to AADs or cannot tolerate them due to side effects, requiring them to be stopped within the first year.

When used correctly, treatment with AADs is safe and may reduce the likelihood of stroke, heart failure, or death. AADs are economical in the short term but must be used indefinitely to suppress AFib. Some AADs require admission to the hospital to be safely started.

*Source: WebMD Medications for Atrial Fibrillation Treatment: Blood Thinners, Beta-Blockers, and More Jan. 9, 2025 

Electrical cardioversion is performed by administering a carefully dosed electrical shock to the chest, which stops AFib and allows the heart to restore a normal rhythm. Cardioversion is very effective for breaking an episode of persistent AFib but does not prevent future episodes from occurring. For this reason, cardioversion is frequently performed in combination with an AAD medication or ablation to help prevent future AFib episodes.

Catheter ablation is a minimally invasive procedure to create areas of scar that help block the abnormal electrical signals that trigger episodes of AFib. Catheter ablation is highly effective at maintaining normal sinus rhythm and is associated with a low rate of complications or adverse events.

  • After a single procedure, 80-94% of patients with paroxysmal AFib and 60-70% of patients with persistent AFib are AFib-free at one year
  • Reduces the need for unplanned ER visits and hospitalizations by up to 80%
  • Reduces the symptoms of AFib and improves the quality of life
  • Complications are rare, occurring in only 1.8% of patients

How is catheter ablation performed?

  • Large bore IVs are inserted into the veins in the groin using ultrasound guidance
  • Catheters are advanced through the IVs to the heart
  • Ultrasound, 3-dimensional mapping, and sometimes X-ray tools are used to position the catheters correctly
  • Typically heat or cold energy is then applied to the heart tissue to block the abnormal electrical signals from the rest of the heart
  • Inova also offer a newer approach to ablation using pulsed field ablation (PFA). Instead of heat or cold energy, PFA uses short bursts of high-frequency electric shock. PFA may result in a more durable ablation, lowering the chance that electrical connectivity will be restored to the area(s) where the ablation is trying to prevent it.

For patients who continue to experience AFib following treatment, we offer hybrid or "convergent" therapies which integrate minimally invasive surgical epicardial ablation with endocardial catheter ablation. Cardiac surgeons work in tandem with an electrophysiologist to perform these procedures.

By teaming up, EP specialists and cardiac surgeons can reach more problem areas on the surface of the heart to help patients return to a better quality of life when they haven't responded to less invasive interventions.