Heart Rhythm Program

At Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, our knowledgeable, highly-experienced cardiology team is dedicated to providing the most advanced and accurate diagnostic options for heart rhythm disorders (arrhythmias) in Orange County. Why? Because that’s how we get to the highest-quality and most appropriate treatment plan for every arrhythmia patient, every time.

From understanding the causes behind less-dangerous arrhythmias like occasional episodes of atrial fibrillation, to the diagnosis and treatment of potentially life-threatening arrhythmias like ventricular tachycardia, Hoag is the clear choice in Orange County for advanced diagnostic testing and monitoring for conditions that can cause an abnormal heartbeat and impact the heart’s rhythm.

Read on to learn more about the diagnostic options for arrhythmia available at Hoag. If you are concerned about heart rhythm disorders, contact Hoag today by calling 949-764-8111.

At Hoag, tests, procedures and methods we use to diagnose and develop treatment plans for cardiac arrhythmia include:

• The Allan & Sandy Fainbarg Electrophysiology Cath Lab Suite: A key facet of Hoag’s top-rated heart rhythm program and the first of its kind in Orange County, the state-of-the-art Cath Lab Suite is a comfortable, relaxed and patient-focused hub for heart health, advanced technology and the next-generation diagnosis and treatment of arrhythmias and other cardiac conditions.

• Electrophysiology Studies: Electrophysiology studies, also called an “EP study” are used to assess the heart’s electrical system and the impulses that regulate cardiac rhythm and contractions of the heart muscle. The result of these studies can help healthcare providers isolate the cause and source of heart arrhythmias.

• Electrocardiograms (EKG): Electrocardiogram testing, or EKG, is a non-invasive electrophysiology-related test that measures the coordination and the electrical signals that control the heart rhythm.

• Echocardiogram: Echocardiograms utilize high-frequency sound waves called “ultrasound” to create detailed images of the heart without ionizing radiation or invasive techniques. These images can reveal hidden details about the heart, including whether an arrhythmia may be caused by a structural issue, a heart valve problem or other disorder.

• Transesophageal echocardiogram (TEE): At Hoag, one advanced form of echocardiography we use is transesophageal echocardiogram, which involves passing a small ultrasound source down the esophagus, which places it closer to the heart. Once the ultrasound source is activated, this technique allows specialists to capture clearer and more detailed images of the heart, without structures like the ribs, chest muscles and sternum in the way.

• Event recorders: An event recorder is a wearable device designed to monitor and record information about irregular heart rhythms for up to a month. Usually connected to the chest with sticky pads that conduct electricity through the skin, an event recorder is a small device about the size of a key fob. If an arrhythmia episode like atrial flutter occurs while wearing the event recorder, the patient presses a button on the device that notes the exact date and time of the symptom, then writes down their account of the symptom they experienced in a provided event log. This helps arrhythmia specialists isolate the electrical signals associated with the event so those particular readings can be studied.

• Holter Monitoring: Another type of wearable device used to monitor an irregular heartbeat, a Holter monitor is a small electronic device that records cardiac activity and the heart rhythm continuously for between one and three days. Holter monitor testing is usually performed if other heart rhythm and function tests like an electrocardiogram don’t provide conclusive results or don’t fully reveal the underlying cause of a cardiac arrhythmia.

• Stress testing: A stress test helps diagnose arrhythmias that may be triggered by exercise or physical stress, and can be particularly helpful in determining if arrhythmia is caused by heart disease or coronary artery disease. During stress testing, doctors usually monitor the heart’s electrical activity for abnormal heartbeats while the patient is doing some form of exercise, like riding an exercise bike or walking on a treadmill. If a person is too unwell to exercise, drugs may be used to simulate the effects of mild exercise on the body.

• Tilt Table Testing: Tilt table testing is a test that uses a special motorized table to help diagnose slow arrhythmias that may cause fainting. Episodes of fainting, in which a person suffers a partial or complete loss of consciousness, are also sometimes associated with this action. During a tilt table test, factors like blood pressure, heart rate and rhythm are monitored while the tilt table moves the strapped-in patient from a horizontal to a vertical position.

Hoag’s Jeffrey M. Carlton Heart & Vascular Institute has been an Orange County beacon of help, hope and healing for serious cardiovascular diseases, including heart disease, coronary artery disease, high blood pressure, heart problems that can result in blood clots and stroke and other issues that can impact blood flow and heart health.

For those who suffer with abnormal heart rhythms in Orange County, Hoag’s unique Heart Rhythm Program is second to none. We’re committed to excellence in patient-centered care, and dedicated to delivering the advanced treatments and diagnostic options for arrhythmia that you need to heal.

From atrial fibrillation to ventricular fibrillation, paroxysmal supraventricular tachycardia to heart arrhythmias that involve the heart’s natural pacemaker, the sinus node, Hoag’s multidisciplinary team of cardiologists, electrophysiologists, and cardiothoracic surgeons stands ready to help every patient in Orange County meet the challenge of complex cardiac arrhythmia.

Visit our arrhythmia overview page or arrhythmia treatment options page to learn more.

Contact Hoag’s Heart Rhythm Disorders Program by calling us at 949-764-8111.

Finding the right combination of medications, lifestyle changes and procedures to treat complex heart rhythm conditions can sometimes be a long and confusing process. Some patients with dangerous or difficult-to-control arrhythmias may even need a surgical procedure like cardiac ablation or an implanted medical device to help control the heart’s electrical activity.

At Hoag’s state-of-the-art Jeffrey M. Carlton Heart & Vascular Institute, our experienced electrophysiologists and heart rhythm team is always responsibly pushing the envelope when it comes to new and promising treatments for arrhythmias. From atrial fibrillation to more dangerous arrhythmias like ventricular tachycardia, as a high-volume arrhythmia treatment program in Orange County, Hoag has the deep experience and advanced treatment options you need to come back strong from a heart arrhythmia diagnosis.

With a program-wide focus on patient-centered, comprehensive care and follow-up, Hoag’s Heart Rhythm Program has helped thousands of Orange County patients achieve heart health, reduce symptoms and control their cardiac arrhythmia so they can get back to doing what they love.

Read on to learn more about the treatment options for arrhythmia available at Hoag. If you are concerned about heart rhythm disorders, contact Hoag today by calling 949-764-8111.

At Hoag, treatment options for cardiac arrhythmia include:

• Medical management is often part of the treatment plan for patients with mild or less dangerous types of arrhythmias, including atrial fibrillation. The approach relies primarily on close supervision of the condition by Hoag’s team of arrhythmia specialists, along with lifestyle changes like getting more exercise, eating a heart-healthy diet, and taking prescribed medication as directed to help control the arrhythmia.

• Medications utilized in the treatment of abnormal heartbeat may include anti-arrhythmics and anticoagulants to help prevent blood clots.

• Electrical Cardioversion: For cardiac arrhythmia patients whose symptoms aren’t well-controlled by medications alone, electrical cardioversion is an option available at Hoag in Orange County. During the procedure, an electrical shock is delivered to the heart. This shock can resynchronize the heart, disrupting the signals causing an abnormal heart rate or rhythm and allowing a normal rhythm to begin. Basically, it’s like rebooting the heart’s electrical system. This is often used in conjunction with medications.

• Catheter Ablation: If other treatments are ineffective in controlling a patient’s abnormal heart rhythms, catheter ablation may be an option. Ablation treats an abnormal heart rhythm by burning or freezing specific portions of the heart that contribute to arrhythmias. This creates scar tissue which can disrupt the transmission of the signals responsible for abnormal heartbeats. During the procedure, an electrophysiologist guides a thin, flexible catheter through the cardiovascular system to the heart. Once in place, the catheter emits energy that destroys a portion of the heart tissue. Hoag’s team of cardiothoracic surgeons and electrophysiologists at the Jeffrey M. Carlton Heart & Vascular Institute are experienced in catheter ablation.

• Hybrid Surgical-Catheter Ablation: Also known as convergent ablation, hybrid surgical-catheter ablation combines catheter ablation and surgical ablation to treat difficult-to-control arrhythmia symptoms. Hoag is a national teaching center for Hybrid Surgical-Catheter Ablation, helping train surgeons from across the U.S. in this groundbreaking procedure. Visit this link to read the story of a Hoag Afib patient whose life was changed by the groundbreaking technique.

• Total Thoracoscopic Maze Procedure: Hoag was the first cardiac treatment center in Orange County to use the Total Thoracoscopic Maze Procedure to treat chronic atrial fibrillation, and our advancement of this procedure has never stopped. During a Total Thoracoscopic Maze Procedure, instruments are inserted through incisions in the chest. A cardiovascular surgeon then ablates lines on the heart. These lines eventually form scar tissue, which can block or alter electrical signals that disrupt the heart’s rhythm and cause atrial fibrillation and other forms of arrhythmia.

• Surgical ablation (Maze procedure) or surgical concomitant Maze: During a Maze procedure (also called a Cox Maze procedure), a cardiovascular surgeon makes a series of incisions in the right and left atriums (upper chambers) of the heart. As the incisions heal, scar tissue forms in the heart muscle. This scar tissue interrupts the transmission of the electrical signals that cause atrial fibrillation. When a Maze procedure is performed during bypass surgery or heart valve surgery, it’s known as a surgical concomitant Maze procedure.

• Left Atrial Appendage Closure with the WATCHMAN™ LAA Implant: Left Atrial Appendage Closure that helps patients with persistent atrial fibrillation avoid blood clots, stroke and is an alternative to blood thinners by closing off the Left Atrial Appendage (LAA). The LAA is a small pouch in the wall of the left atrium of the heart. The majority of blood clots experienced by Afib patients begin in the LAA. By closing it off, the risk of stroke and the need to use blood thinners is greatly reduced for those with Afib. At Hoag, we utilize the advanced WATCHMAN LAA Closure Implant. The implant has helped more than 300,000 patients worldwide. Learn more about the WATCHMAN LAA Closure device.

• Traditional Pacemaker: A pacemaker is a small medical device that is programmed to sense abnormal heart rhythms and produce electrical impulses that return the heart into a healthier and more normal rhythm. Usually, a traditional pacemaker is surgically implanted under the skin near the collarbone, and connected to the heart with thin wires, called “leads,” through a cardiac vein.

• Leadless Pacemaker: Unlike a standard or traditional pacemaker device, a leadless pacemaker eliminates the need for wires connecting the device to the heart. Installed through less-invasive procedures, leadless devices provide fewer complications and a faster recovery for many patients with heart problems. Hoag was one of the first cardiac treatment centers in the United States to utilize the world’s first leadless, dual-chamber pacemaker, AVEIR™ DR by Abbott™. Visit this link to read the story of a lifelong athlete who got back in the game thanks to Hoag surgeons and this next-generation device. This leadless technology is available for single and dual chamber pacing.

• Implantable Cardioverter Defibrillator (ICD): A small device that is usually implanted in the chest, an implantable cardioverter-defibrillator detects life-threatening arrhythmias, then automatically delivers an electrical shock to restore the normal heart rhythm, reducing the risk of death during life-threatening arrhythmia event.

• Biventricular Implantable Cardioverter Defibrillator and/or Pacemaker: A specialized form of implantable ICD device, the Biventricular Implantable Cardioverter Defibrillator is often recommended for patients with arrhythmia due to severe left ventricular heart failure. The biventricular ICD has leads (wires) that attach to the heart’s right ventricle and left ventricle (the lower chambers). Pacing both lower chambers can improve symptoms from heart failure and reduce morality.

Hoag’s Jeffrey M. Carlton Heart & Vascular Institute has been helping our neighbors in Irvine, Newport Beach, Anaheim, Costa Mesa, Huntington Beach and other communities across Orange County find the advanced treatments they need for serious cardiac conditions, including heart failure, heart attack, coronary artery disease, long-term high blood pressure and more.

Our commitment to those with disorders like atrial fibrillation, supraventricular tachycardia (SVT), ventricular tachycardia and other conditions that can cause irregular heartbeat is just as strong. From advanced diagnostic techniques to groundbreaking surgical procedures, arrhythmia management to next-generation implantable devices that can detect abnormal electrical signals in the heart and stop a potential cardiac arrest in its tracks, Hoag is always looking for the latest and most advanced treatment options for cardiac arrhythmia.

Visit our heart rhythm conditions page or arrhythmia diagnosis and testing page to learn more.

Contact Hoag’s Heart Rhythm Disorder Program by calling (949) 764-8111.