Inova offers two new, leading-edge technologies to treat and prevent AFib
Atrial fibrillation (AFib) is the most common type of irregular heart rhythm, affecting more than 12 million people in the United States. When a person is experiencing AFib, the heart’s top two chambers are not beating in sync with the heart’s lower two chambers. This means that blood is not flowing through the heart efficiently, causing symptoms like heart palpitations, fatigue, chest pain and shortness of breath. Having AFib also significantly increases a person’s risk of having a stroke.
Inova leads the region in AFib care through the Inova AFib Center, which offers a comprehensive, multidisciplinary approach to managing and treating AFib to reduce symptoms and stroke risk. Our electrophysiology (EP) experts, who specialize in treatment for heart rhythm disorders including AFib, use leading-edge technologies to treat patients with, or at risk of developing, AFib.
Reducing risk of AFib in patients with pacemakers
A pacemaker is often recommended for patients whose hearts beat too slowly. The pacemaker is a device that is implanted under the skin and prompts the heart to keep pace in a normal rhythm. However, implanting a pacemaker using traditional methods can cause the patient to develop AFib within a few years.
One of the main reasons this happens has to do with where the pacemaker’s wires connect to the heart. The wire placement can enlarge the heart’s top chambers or affect the electrical conduction pattern, resulting in AFib. But Inova’s EP teams are at the forefront of a new way to implant a pacemaker that doesn’t raise AFib risk.
“We are collaborating with other leading health systems to develop a new and better way to pace the heart in order to try to prevent AFib from occurring,” said Brett Atwater, MD, D’Aniello Chair, Atrial Fibrillation and Section Chief of Electrophysiology at Inova Schar Heart and Vascular. “And that is through the use of a new location for placement of the atrial pacing wire: the Bachmann bundle.”
The Bachmann bundle is a small section of muscle in the heart that can quickly send an electrical signal to both of the heart’s top chambers. Inova is the only hospital in the Washington, DC, metropolitan area to offer Bachmann bundle pacing. By stimulating the Bachmann bundle, which connects the heart’s two top chambers, the pacemaker’s electrical signals mimic the heart’s normal electrical pathway. This leads to better heart function and less AFib.
Inova’s EP team is now in the planning phases of a major randomized, controlled trial that will measure Bachman bundle pacing’s impact on how much, if any, AFib patients experience after a pacemaker implantation to treat a too-slow heart rhythm.
Second-generation pulsed field ablation (PFA) lowers risk and improves outcomes – including for those with prior ablations
Since 2021, Inova Schar Heart and Vascular has participated in several clinical trials for PFA and, thanks to a generous gift from a grateful patient, was the 14th hospital in the U.S. to get access to Medtronic’s Affera™ system, a second-generation PFA system for AFib treatment. PFA uses short bursts of high-frequency electric shock to destroy the cells that are misfiring and causing the AFib without damaging other parts of the heart. PFA may result in longer-lasting ablation, lowering the chance that the patient’s AFib will come back.
While first-generation PFA systems have been available since early 2024, this second-generation version became available in January 2025. With five Affera systems at three locations across the health system, including Inova Alexandria, Inova Fairfax and Inova Loudoun hospitals, Inova electrophysiologists have performed more ablations with the Affera system than anywhere else in the world – more than 1,100 and counting. Inova is the only health system in the DMV to offer AFib ablation with the Affera platform.
“The Affera system allows for faster procedures and potentially safer procedures. It also allows us to be much more flexible,” Dr. Atwater said. “It enables us to do exactly the procedure that we believe the patient needs, rather than a standard approach for everybody.”
The Affera system has several benefits that contribute to its safety. First, it makes the procedure faster, reducing risk. Second, its precision form factor enables Inova’s EP teams to deliver energy more exactly, sparing healthy tissue. It has also been shown to have the highest chance of long-lasting normal heart rhythm, especially for those experiencing persistent forms of AFib or those with a prior ablation.
Inova Schar Heart and Vascular continues to conduct outcomes research and collect data on effectiveness. Inova’s team has taken on the most challenging AFib cases, including people who have long-standing persistent AFib, using this system.
“It’s allowing us to take on more challenging cases, and we’re doing them safely and with effective results,” Dr. Atwater said. “This has expanded our ability to take care of AFib, which has been very meaningful for our patients.”
Learn more about Inova’s heart rhythm expertise
Inova Schar Heart and Vascular is a regional and national leader in EP innovations, bringing the latest FDA-approved devices and clinical trials of next-generation technologies to patients. Inova is committed to offering these technologies across the health system at multiple hospitals. No matter where patients are seen at Inova, they have access to the best available treatments and technologies.
Physicians currently trained to perform the Bachmann bundle atrial pacing technique and use the latest pulsed field ablation technology for treatment of AFib include: