Inova’s AFib center can partner with your existing cardiologist or primary care physician to fully address your needs at various stages of treatment, using protocols for standardized practice to assure delivery of high-quality, guideline recommended, state-of-the-art care.

Our physicians identify each patient's type of arrhythmia and site of origin using the most advanced computerized 3-dimensional mapping equipment in our state-of-the-art electrophysiology labs. From here, we offer patients a full range of treatment options based on their unique needs, including the latest techniques, less invasive treatments, personalized medication, and emerging therapies through clinical trial partnerships.

Our team performs a high volume of procedures each year and brings a wealth of experience to your care. In 2021, we performed 1,564 ablations, 1,341 cardiovascular implantable electronic device (CIED) procedures, 55 CIED lead extractions, and 111 WATCHMAN™ procedures.

Electrophysiology data


Lead Extraction for Cardiovascular Implantable Electronic Devices: 52

IAC Badge - Cardiac Electrophysiology

Accredited for:

  • Testing and Ablation
  • Device Implantation
  • Chronic Lead Extraction

Patient and procedural volumes for 2020 were impacted by a temporary suspension of elective procedures due to COVID-19 beginning in March through the end of May and the nationwide trend of decreased demand for services throughout the pandemic.

Inova may offer virtual appointments to new or existing patients in Virginia, and existing patients from Washington, DC, Pennsylvania or West Virginia. Please call our office at 571-472-2342 to discuss your needs and eligibility for virtual appointments.

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 converting episodes of AFib to a normal rhythm and preventing future episodes of AFib from occurring. They can reduce symptoms of AF and improve the quality of life in the first year of use.

  • 33-56% of treated patients maintain a normal heart rhythm in the first year of treatment.
  • 50% of 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.

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
  • Heat or cold energy is then applied to the heart tissue to block the abnormal electrical signals from the rest of the heart

rhythm control chart

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.