Atrial fibrillation (AF or AFib) is the most common heart rhythm abnormality that starts in the atria. Approximately 2.2 million people in America and 4.5 million in the European Union have paroxysmal or persistent AF. Atrial fibrillation increases with age and is a major cause of stroke.
When someone has AF, the sinus node (SA node) doesn’t properly direct the heart’s electrical rhythm. Many different impulses rapidly fire at the same time, causing a very fast and chaotic rhythm in the atria (upper chambers of the heart). Because the electrical impulses are so fast and chaotic, the atria cannot contract and/or squeeze blood effectively into the ventricles (lower chambers of the heart). This decreases the heart’s pumping ability and increases the risk for blood clots.
Cleveland Clinic's Center for Atrial Fibrillation is a multidisciplinary specialty treatment group dedicated to the diagnosis and treatment of AF– whether it is chronic (persistent) or paroxysmal (comes and goes). Since 2004, we have seen thousands of patients in the center. This experience and knowledge, combined with a caring staff, provides you with quality patient care.
- Atrial Fibrillation
- 2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation
- Atrial Fibrillation – American Heart Association
- Atrial Fibrillation Heart Rhythm Society
The Center for Atrial Fibrillation brings together specialists from cardiology, electrophysiology, cardiac surgery, cardiac imaging and arrhythmia research with expertise in diagnostic testing, medical management, and interventional and surgical procedures for patients with:
Our team of health care professionals specializes in the care of patients with atrial fibrillation and provides patients with a full range of treatments aimed at rhythm control, rate control and stroke prevention strategies such as:
- A full range of imaging techniques and diagnostic studies designed to diagnose atrial arrhythmias, including electrocardiogram (ECG), ambulatory monitoring, echocardiogram and transesophageal echocardiogram
- Medical management, including the most current medication regimens to control rate, rhythm and prevent blood clots from forming
- Pulmonary vein isolation ablation, an interventional, catheter-based procedure to treat AF, as well as a full range of ablation techniques to treat other types of supraventricular arrhythmias
- Traditional and minimally invasive surgical procedures for atrial fibrillation (Maze procedure) that can be combined with other heart surgeries to fully treat the patient’s heart condition
- Device therapies, when needed, to control the heart rate
- Left atrial appendage closure.
Why choose Cleveland Clinic for your care?
Our outcomes speak for themselves.Please review our facts and figures and if you have any questions don’t hesitate to ask.
The Center for Atrial Fibrillation staff includes a multi-disciplinary group of health care professionals from various Sections and Departments within the Heart and Vascular Institute – designed to provide you with the best expertise to treat your atrial fibrillation.
- Walid Saliba, MD - Co-Medical Director, Center for Atrial Fibrillation; Director, Electrophysiology Lab; Staff Cardiologist, Section of Cardiac Electrophysiology and Pacing
- Oussama Wazni, MD - Co-Medical Director, Center for Atrial Fibrillation; Director, Outpatient Electrophysiology Department; Staff Cardiologist, Section of Cardiac Electrophysiology and Pacing
- A. Marc Gillinov, MD - Surgical Director, Center for Atrial Fibrillation; Staff Cardiac Surgeon, Sydell and Arnold Miller Family Heart & Vascular, Institute Experience Officer, Heart & Vascular Institute
Our Medical Team
Miller Family Heart & Vascular Institute: Cardiovascular Medicine, Section of Electrophysiology and Pacing
- Bruce Lindsay, MD, Section Head
- Bryan Baranowski, MD
- Mandeep Bhargava, MD
- Thomas Callahan, IV, MD
- Daniel Cantillon, MD
- Mina Chung, MD
- Thomas Dresing, MD
- Mohamed Kanj, MD
- Khaldoun Tarakji, MD, MPH
- David Martin, MD, MPH *
- Mark Niebauer, MD
- Walid Saliba, MD
- Patrick Tchou, MD
- Niraj Varma, MD, PhD
- Oussama Wazni, MD
- Bruce Wilkoff, MD *
- Christine Tanaka-Esposito, MD (Avon Location)
* Diagnoses and treats patients with atrial fibrillation, but does not perform ablations
The Center for Atrial Fibrillation support nurses are available to answer your questions throughout your care at Cleveland Clinic. These include:
- Chad Anderson, BSN, RN
- Charlotte Bacho, MSN, A-GNP-C
- Polina Engelhardt, MSN, NP-C
- Megan Eppich, RN
- Shannon Heidrick, BSN, RN
- Lauren Jamieson, BSN, RN
- David Janiszewski, MSN, ANP-BC
- Any Knesebeck, BSN, RN
- Christina Magnelli-Reyes, BSN, RN
- Maria Matteo, BSN, RN
- Tracy Mauric, BSN, RN
- Jillian Perini, MSN, ANP-BC
- Stacy Poe, MSN, NP-C
- Val Proa, BSN, RN
- Sue Sima, BSN, RN
- Darlene Youngblood, MSN, RN
Miller Family Heart & Vascular Institute: Cardiovascular Medicine, Section of Imaging
The Miller Family Heart & Vascular Institute’s team of imaging specialists are experts in diagnosing underlying heart conditions that can lead to AF.
Miller Family Heart & Vascular Institute: Cardiothoracic Surgery
Surgical procedures for AF include the Maze procedure (traditional, minimally invasive or robotically assisted) and the modified Maze procedure combined with other cardiac surgical procedures, such as mitral valve surgery:
- Joseph Sabik, MD, Chairman
- Gosta Pettersson, MD, PhD, Vice-Chairman
- A. Marc Gillinov, MD*
- Douglas Johnston, MD
- Stephanie Mick, MD
- Tomislav Mihaljevic, MD
- José Navia, MD
- Eric Roselli, MD
- Nicholas Smedira, MD
- Edward Soltesz, MD*
- Lars Svensson, MD, PhD
* Special interest in surgical treatments for atrial fibrillation
Other members of your healthcare team may include dietitians, exercise specialists and psychological support staff. Your care will be based on your individual needs and coordinated by the Center for Atrial Fibrillation.
What to Expect
Whether you are coming from around the corner or around the world, you want to know what to expect before, during and after your visit with us. If you have any questions while reviewing this information, please contact us. We are happy to answer any questions you may have.
Before Your Appointment
If your appointment is at least one week away, you will be asked to send in the following:
- Name, address and contact phone number(s)
- Insurance information
- Rhythm strip or EKG documenting your arrhythmia (atrial fibrillation)
- Echocardiogram report (CD is not necessary)
- Other cardiac test results, such as stress test or cardiac catheterization reports
- Medical records pertinent to your cardiac condition
- Recent history and physical exam report
- If you have had an ablation, you will be asked to send an electrophysiologist report from the procedure
All information should be sent in the same package (clearly marked with your name and address) via DHL, Federal Express or certified US mail. Make sure you get a tracking number for your package.
Information should be sent to:
Center for Atrial Fibrillation
Electrophysiology and Pacing - Desk J2 - 2
Attn: Stacy Poe, RN
9500 Euclid Ave
Cleveland, OH 44195
If your appointment is less than a week away, please bring your records to your appointment.
Traveling to Cleveland Clinic
When you make your appointment, we would like to make traveling to Cleveland Clinic as easy as possible. Information on travel to the Miller Family Heart and Vascular Institute.
During Your Appointment
When you arrive at Cleveland Clinic for your initial appointment, you will first meet with a registered nurse, nurse practitioner, or physician assistant who will begin the interview process and ask you about your medical history and your atrial fibrillation. You might be asked to fill out a questionnaire about your atrial fibrillation.
Then, you will meet with a physician from the Center for Atrial Fibrillation. The physician will explain your treatment options for atrial fibrillation. Once you have agreed upon a treatment option, you may need additional tests to provide more information about your condition.
One treatment option is the use of anti-arrhythmic medication. Some medications require you to stay in the hospital when the medication is started. If your plan involves one of these medications, your doctor will give you more information.
Some patients with atrial fibrillation may benefit from the catheter based Pulmonary Vein Isolation (PVI) procedure. Your physician will decide if you are a candidate for this procedure based on your medical history and test results. If you are a candidate, a procedure date will be scheduled for you.
How long will you need to stay at Cleveland Clinic?
You should plan on staying one day for your initial consultation. If you need to have additional tests, you may need to return the next day, depending on the test schedule.
Certain anti-arrhythmic medications require telemetry monitoring when the medication is started. If your treatment plan includes one of these medications, you will need to stay in the hospital three nights.
If you are scheduled for PVI, you will stay in the hospital the evening of the procedure, and you will likely go home the next day. If you live more than two hours from Cleveland Clinic, we ask that you stay an additional night in the area at either a hotel or a local family member’s home.
After Your Visit
Your doctor will tell you when you need to be seen again.
If you have PVI, you will be seen 3 to 4 months after the procedure. At your follow-up visit, you will have testing that may include a cardiac CT scan, EKG, echocardiogram and/or blood work. You will meet with a member of the Center for Atrial Fibrillation nursing staff and with your physician.
Toll-free 800.223.2273, ext. 49162 for evaluations for medical management or pulmonary vein isolation procedures
Toll-free 877.843.2781 (877.8Heart1) for evaluations for surgical treatment for atrial fibrillation, including minimally invasive techniques combined with other heart surgery procedures
Go to Desk J1 - 5, 9500 Euclid Avenue, Cleveland, Ohio.
Use our secure online form to submit an appointment request 24/7. We will receive it and follow-up with you as soon as possible.
Mon. - Fri., 8 a.m. - 5 p.m. (ET):
toll-free 800.223.2273, ext. 49162
Cleveland Clinic Heart and Vascular Institute physicians, surgeons, and researchers continue to research into new treatments and therapies with the goal of improving patient care and outcomes into the future.
Basic Research Efforts
The Miller Family Heart & Vascular Institute is well equipped for state-of-the-art clinical, basic, and translational research efforts. Research into the mechanisms underlying atrial fibrillation (AF) and new treatments for AF is being conducted at each of these levels. One of the fundamental characteristics of this effort is its collaborative nature. Studies typically involve clinicians, surgeons, and scientists, interacting on a frequent basis. This integration and coordination gives us the ability to overcome the traditional boundaries to translational research efforts.
Cleveland Clinic has modern and well equipped laboratory facilities for basic cardiac electrophysiology research. Research facilities include approximately 2000 square feet of laboratory space, immediately adjacent to the hospital, with state of the art equipment for doing a broad spectrum of electrophysiology research at multiple levels - from the isolated cardiac myocyte (heart muscle cell), to the isolated heart or cardiac tissue, to whole animal studies, and finally to collaborative clinical studies.
For more information about the Center for Atrial Fibrillation basic research efforts contact David Van Wagoner, PhD.
Atrial Fibrillation Stroke Prevention Center
Many patients with atrial fibrillation are at risk for stroke and need anticoagulation therapy. However some patients have a high risk of bleeding with long term use of this type of therapy. This is especially true if the patient is frail or has a history of bleeding, such as bleeding in the stomach or intestines and/or brain (cerebral hemorrhage). New medications and procedures are available to help manage the risks of both stroke and bleeding in these patients with atrial fibrillation.
The staff of Cleveland Clinic’s Stroke Prevention Center is highly experienced and able to help patients with these needs.
Our Medical Team
Our multidisciplinary team includes specialists in cardiology, vascular medicine, gastroenterology and neurovascular medicine. We work together to assess your risk of stroke and bleeding and develop a treatment plan that best meets your individual needs.
Co-Directors: Oussama Wazni, MD and Walid Saliba, MD
Miller Family Heart & Vascular Institute
Cardiovascular Medicine – Center for Atrial Fibrillation (Electrophysiology)
Oussama Wazni, MD – Cardiovascular Medicine, Section of EP
Walid Saliba, MD – Cardiovascular Medicine, Section of EP
Your initial consultation will be with an electrophysiologist
Other specialists from our multidisciplinary team may also take part in your care.
Miller Family Heart & Vascular Institute
Cardiovascular Medicine – Imaging Section
Richard Grimm, DO
Wael Jaber, MD
Leonardo Rodriguez, MD
Cardiovascular Medicine – Invasive and Interventional Cardiology
Samir Kapadia, MD - Section Head, Invasive/Interventional Cardiology
Cardiovascular Medicine – Vascular Medicine Thrombosis Center
John Bartholomew, MD – Cardiovascular Medicine, Section Head of Vascular Medicine and Medical Director, Thrombosis Center
Digestive Disease Institute
Gastroenterology and Hepatology
Chung-Jyi Tsai, MD, PhD - Gastroenterology and Hepatology, Staff
Megan Donohue, MD - Neurovascular Medicine
Muhammad Shazam Hussain, MD – Head, Cleveland Clinic Stroke Program
Make an Appointment
The Atrial Fibrillation Stroke Prevention Center is located at Desk J2-2, on the second floor of the Sydell and Arnold Miller Family Heart & Vascular Institute.
To make an appointment, please call toll-free 216.444.0400. Let the scheduling coordinator know if you are having acute symptoms.
Before your appointment
If your appointment is scheduled at least one week in advance, you will be asked to send in your records, including medical history, test results and films (such as echocardiogram, chest X-ray, MRI or CT). All information should be sent in the same package (clearly marked with your name and address) via Airborne Express, Federal Express, or certified U.S. mail (make sure you have a tracking number) to the physician you will be seeing. The address is:
Stroke Prevention Center
Center for Atrial Fibrillation
9500 Euclid Avenue – Desk J2-2
Cleveland, OH 44195
If your scheduled appointment is within a week, please bring your records to your appointment.
What to expect during your appointment
You will meet with a nurse who will collect your information and begin the documentation process.
Based on your medical history, you will have specialized blood work and imaging tests (electrocardiogram, comprehensive transthoracic echo, transesophageal echo, cardiac MR and multidetector CT scanning, EGD).
You will meet with a cardiologist from the clinic who will review your records and medical history, perform a physical examination, review your test results, and provide you with an assessment and plan.
If you need to meet with one of the other multidisciplinary specialists, they will be consulted in one - two days.
How long will you need to stay at Cleveland Clinic?
To complete all testing, you will need to stay in the Cleveland area for one to two days.
If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.