Atrial Fibrillation (Afib) and other Arrhythmias
Heart Rhythm Disorders
Duke's heart rhythm specialists use the latest medical advances to ensure you receive personalized treatment for arrhythmia, including atrial fibrillation (Afib) and ventricular tachycardia. With appointments available in Durham, Raleigh, Sanford, Lumberton, Burlington and Danville, VA, our experts in irregular heart rhythms, catheter ablation and implantable cardiac devices help you manage your symptoms and return your heart to a normal rhythm. We want to lower your risk for heart failure and stroke so you can lead a more active life.
Advanced Arrhythmia Care
Our specially trained cardiac electrophysiologists treat nearly 1,700 arrhythmia patients each year -- among the highest number in the Southeast. We continually evaluate new treatment approaches, and have achieved some of the lowest complication rates associated with catheter ablation, a common treatment for atrial fibrillation (Afib) and ventricular tachycardia. Our research and expertise help set the standard for arrhythmia treatment nationwide.
Choose a Duke heart clinic for your arrhythmia treatment because we offer:
- Top-ranked care. U.S. News and World Report ranks Duke Heart Center among the best cardiology and heart surgery programs in the nation, based on our patients’ survival rates, the number of procedures we perform, and the quality of our support services.
- Excellent outcomes the first time. We use sophisticated heart mapping techniques to identify which part of the heart to target for catheter ablation. Computer-guided treatments stabilize the catheter and more accurately guide its movement within the heart. As a result, the problem area is treated and the likelihood of repeat procedures is reduced. In fact, over the past two years, fewer than ten percent of our patients have needed a repeat ablation, a rate less than half the average.
- Advanced techniques. Your catheter ablation procedure will be performed by electrophysiologists trained in the most advanced ablation techniques available, including mapping for spiral waves and focus beats, which can shorten procedure time.
- Specialized procedures for less common arrhythmia. Duke is among a handful of centers with substantial expertise in epicardial catheter ablation, which treats ventricular tachycardia that occurs on the heart’s outer surface.
- Skilled geneticists. Our genetic heart disease program is one of the only centers in the Southeast with adult and pediatric experts who can interpret the complex tests required to identify inherited heart rhythm disorders such as the long QT and Brugada syndromes. Pinpointing the cause of your arrhythmia helps us take a proactive approach to treatment, prevents the possibility of sudden cardiac death, and ensures your family is well-informed of any increased risk.
- Specialists at removing pacemakers. Our team includes specialists skilled in removing pacemakers and defibrillator leads when necessary. This complex procedure is performed alongside heart surgeons who can provide surgical support. Nearly 95 percent of our patients have their leads removed without the need for open heart surgery.
- Expertise in optimizing devices. Cardiac resynchronization therapy can be very beneficial for patients with heart failure and arrhythmia, but some patients do not respond to the therapy at first. We use cardiac MRI to help identify problems and optimize pacing treatment.
- Long-term care for implanted devices. If you have an implanted device, we provide comprehensive, long-term care to ensure it functions properly and is not subject to device recalls.
- Options for high-risk patients. We assess and care for patients with prior unsuccessful catheter or surgical ablation. We seek to provide hope to people with complex heart rhythm conditions.
- New ways to manage and reduce stroke risk. Our colleagues led the research studies that resulted in the FDA approval of new "blood-thinning" drugs (or anticoagulants) designed to reduce stroke risk. We are also implanting newly approved devices designed to prevent blood clots that can cause stroke. The devices eliminate the need for anticoagulant medications in patients who are at risk for bleeding complications.
When you have atrial fibrillation, ventricular tachycardia or other forms of arrhythmia, prompt treatment is key to your heart health.
Slow the heart rate, stabilize irregular heartbeats and reduce the effects and risks of an abnormal heartbeat. Blood thinning (anticoagulants) medications may be prescribed to reduce stroke risk following atrial fibrillation. Two of the three newer anticoagulants were studied at Duke, which gives us the knowledge and expertise to reduce stroke risk in people with atrial fibrillation while minimizing potential bleeding complications.
A minimally invasive procedure that uses energy to cauterize the exact heart regions where irregular heartbeats originate. We perform the full range of standard and investigational ablation techniques in our four catheterization labs.
Performed through incisions in the chest. Often offered with other heart surgeries such as coronary bypass surgery or surgery to repair leaky or narrowed heart valves.
Leads from implanted devices that malfunction, fracture or are linked to infection are removed by eletrophysiologists and surgeons who work together in our hybrid operating rooms. As a result of our experience, nearly 95 percent of leads are removed without open heart surgery.
Stimulate and reset the heart's rhythm. We implant more than 1,000 pacemakers, defibrillators and arrhythmia management systems annually. Many times we use a nonsurgical approach, during which leads are inserted into the heart through a vein under the collarbone, to minimize risk and shorten recovery time.
Newly approved devices are implanted during a minimally invasive procedure to close off or block the area of the heart where blood clots that cause stroke are most likely to form.
Duke heart rhythm specialists use many different types of tests and imaging to accurately diagnose your arrhythmia. Your doctor will choose which tests are appropriate for you.
Small electrodes placed on the skin record the heart’s electrical activity and help diagnose arrhythmia.
Uses ultrasound to capture images of the heart to measure size, shape and function.
Uses a strong magnetic field to capture images of the heart to measure size, shape, scar tissue and function. It may be used to image the pulmonary veins prior to an atrial fibrillation ablation or ventricles in the heart in the case of ventricular arrhythmia.
Uses X-ray and computerized reconstruction to image the heart or other structures in different slices and angles. It may be used to image the pulmonary veins prior to an atrial fibrillation ablation procedure.
A battery-operated, take-home EKG or ECG monitor uses electrodes to record the heart’s activity over time when arrhythmia symptoms are irregular. A Loop Recorder is an implanted device placed under the skin. It records irregular heart rhythm episodes triggered by the patient.
A 24-hour (or longer) continuous recording of your heart rhythm while you conduct ordinary daily activities outside the hospital.
A motorized treadmill or bicycle is used to increase the workload on the heart to study the heart rhythm, reproduce symptoms or arrhythmias, or diagnose coronary artery disease.
Recording of heart rate and rhythm and blood pressure while the patient is tilted to an upright (near standing) position to try to diagnose causes of fainting.
A thin, flexible wire is inserted through an artery or peripheral vein to stimulate the heart and pinpoint the origin of irregular or infrequent abnormal electrical signals.
Performed during an EP study before ablating any tissue, this involves manipulation of catheters inside or outside the heart to collect electrical signals and often uses computerized systems to help interpret the recordings in order to pinpoint the origin of the arrhythmia.