Heart Rhythm Management

Evaluation and treatment of atrial fibrillation, ventricular tachycardia supraventricular tachycardia

Evaluation and treatment of syncope

Management of antiarrhythmic medications

Left atrial appendage occulsion (Watchman & Watchman FLX)

Electrophysiology studies

Cardiac Ablations: endocardial/epicardial including low and no radiation techniques

Holter monitors, event monitors, and implantable loop recorders

Implantation and management of pacemakers

Implantation and management of implanted cardioverter defibrillators (ICDs), including subcutaneous ICD

Cardiac re-synchronization therapy and biventricular devices


Radio frequency ablation is where one or more flexible, thin tubes (catheters) are guided via x-ray through the blood vessels to abnormal heart muscle tissue. Once there, a burst of radio frequency energy destroys very small areas of the tissue, which give rise to abnormal electrical signals causing rhythm disturbances.

Holter and Event Monitoring

The Holter monitor is an electrocardiographic recording device that utilizes electrodes, which the patient wears for a 24-48 hour period, including during sleep and exercise. The Holter monitor captures the patient’s entire heart rhythm over a 24-48 hour period so that it can be analyzed.

An event monitor is a similar wearable device that the patient takes home for a period of time. Except rather than continuously recording, the patient manually starts on stops the recoding when he or she suddenly begins to experience symptoms of palpitations or heart racing.

Pacemaker Implantation

Pacemakers are miniature devices that can be implanted underneath the skin to monitor and provide control of a patient’s the heart rhythm. Pacemakers are particularly helpful in patients who suffer from heart rhythms which are abnormally slow. Typically, the pacemaker is placed under the skin of the front wall of the heart below the collarbone. Monitoring of the pacemaker is usually done remotely at home with periodic visits to Waco Cardiology Associates.

ICD Implantation

Implanted cardioverter defibrillators (ICDs) are 99 percent effective in stopping life-threatening arrhythmias and are the most successful therapy to treat ventricular fibrillation, a major cause of sudden cardiac death. An ICD is implanted under the skin near the heart and constantly monitors a patient’s heart rhythm. If it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle causing it to beat in a normal rhythm.

The WATCHMAN™ Left Atrial Appendage Closure Device with Delivery System (Watchman device) and WATCHMAN™ FLX Left Atrial Appendage Closure Device with Delivery System (WATCHMAN™ FLX device) are permanently implanted devices intended to prevent blood clots in the left atrial appendage (LAA) from entering the bloodstream. The WATCHMAN™ or WATCHMAN™ FLX device is intended to be used in patients who have atrial fibrillation (AFib) not related to heart valve disease. (non-valvular atrial fibrillation). In AFib, the two upper chambers of the heart (right and left atria) no longer contract together in a coordinated manner and the heartbeat (pulse) becomes irregular. Because the right and left atria no longer contract normally in AFib, the blood flow in the heart can be slower than normal. This change in blood flow may cause blood clots to form. During Afib, most blood clots that develop in the heart develop in the LAA. If this occurs, these blood clots can break loose, travel through the bloodstream, and block a blood vessel in the brain and cause a stroke. Approval expands the indications to include the use of these devices in patients who have non-valvular atrial fibrillation, are at increased risk for stroke, are recommended and suitable for blood-thinning medications (anticoagulation therapy), and have an appropriate reason to seek a non-drug alternative to anticoagulation therapy. In a clinical study, in 395 out of 400 (96%) patients who had WATCHMAN™ FLX device implanted were able to stop taking their blood-thinning medications after 45 days. In addition, over 92% of patients were able to stop taking blood-thinning medications after one year following the implant procedure.

Charles A. Shoultz, III, M.D., F.A.C.C.   •   Rodney A. Brown, M.D., F.A.C.C.
William R. Pitts, M.D., F.A.C.C.   •   Donald S. (Buck) Cross, M.D., F.A.C.C. • Andrew K. Day, M.D., F.A.C.C.
Sherwin F. Attai, M.D., F.A.C.C.   •   Shawn J. Skeen, M.D. F.A.C.C.   •   Harvey R. Chen, M.D. F.A.C.C.
Adam M. Falcone, M.D., F.A.C.C.   •   Brian C. Barnett, M.D., F.A.C.C.   •   Timothy N. Ball, M.D., F.A.C.C.   •   Clay M. Barbin, M.D., F.A.C.C.

Diplomates, American Board of Internal Medicine,
Cardiovascular Disease, Interventional Cardiology, Clinical Cardiac Electrophysiology