Irregular Heartbeats | Miami Cardiac & Vascular Institute
Irregular Heartbeats

Miami Cardiac & Vascular Institute provides screening, diagnosis, prevention and treatment services for irregular heartbeats. Our physicians work with you to help you manage and treat the disease before it has serious consequences. Our goal is to improve your health and quality of life.

Multiple Treatment Options

Institute physicians will design an individualized treatment plan just for you. For example, we may suggest periodic examination for a minor arrhythmia that does not cause problems. We may recommend lifestyle changes or medication to treat mild arrhythmia symptoms. If you experience more-serious irregular heartbeat symptoms, the Institute offers many additional treatment options, including:

Electrophysiology Treatment

Cardioversion. During cardioversion, a defibrillator delivers an electric shock to the heart at a precise moment using an EKG monitor. The goal is to convert the heart’s electrical rhythm to normal. Cardioversion can be effective for patients with rapid arrhythmias that cause atrial fibrillation, supraventricular tachycardia or atrial flutter.

Cryoablation and Radiofrequency Ablation. Ablation means to destroy or remove tissue. Cardiac ablation intentionally destroys the small amount of your heart tissue causing irregular heartbeats. Although ablation can be done with surgery, Institute electrophysiology specialists can also perform cardiac ablation without surgery. The physician inserts a catheter into the heart through a blood vessel in your groin or arm. The catheter is moved to the precise site of the tissue causing the arrhythmia. The physician then destroys the area with cold (called cryoablation) or heat energy (radiofrequency ablation).


Maze Procedure. The maze procedure creates scar tissue where heart tissue is causing arrhythmia or irregular heartbeats. The scar tissue blocks the electrical signals causing these conditions. Cardiac surgeons can create the maze pattern of scar tissue using small incisions during open-heart surgery. Another open method is an open-chest procedure in which the physician uses cryotherapy (cold), radiofrequency (heat) or microwave energy to create the scar tissue. A third option is a minimally invasive procedure; the physician inserts a tiny fiberoptic camera and surgical tools through small incisions in the chest and delivers the energy directly to the heart tissue.

Pacemaker Lead Extraction. A lead is a special wire that delivers energy from a pacemaker to your heart. It is possible for a lead to stop working properly due to the buildup of scar tissue at the tip of the lead or infection at the site of the device and lead implant. A lead extraction is the removal of one or more leads from inside the heart. A lead extraction procedure takes about two to six hours to perform.

There are two approaches to lead extraction:

In the more frequently used subclavian approach, the leads are extracted through an incision in the upper chest, over the subclavian vein.

The femoral approach is used when the subclavian is not possible, and involves removing the leads through a small puncture in the groin, over the femoral vein. A tiny plastic tube is delivered to the precise site where the lead connects to the heart. The tube is placed in the vein and threaded over the lead to its tip, where it attaches to the heart. The lead is then removed. New leads may be connected during the same procedure or at a later time.

Device Implantation

An electrophysiologist or a heart surgeon at the Institute can implant the following:

Pacemaker. Institute physicians can start or regulate a slow heartbeat by implanting a small pacemaker under your skin. The pacemaker sends electrical signals to the heart. This procedure can be effective for patients with sinus bradycardia, sick sinus syndrome or heart block.

Implantable Converter Defibrillator. Similar to a pacemaker, an implantable converter defibrillator, or ICD, can be placed under your skin to treat a fast arrhythmia. The ICD automatically delivers a small electric shock to your heart whenever it starts beating too fast. ICDs can help patients with ventricular tachycardia or ventricular fibrillation.

Anticoagulation Clinic – A Balanced Approach to Medication Management

When you’re taking anticoagulation, or blood thinning, medication, you spend a lot of time and energy managing your heart disease and your medication. Miami Cardiac & Vascular Institute at South Miami Hospital makes life a little easier for anticoagulation patients. The state-of-the-art Anticoagulation Clinic houses specialists who focus on maximizing the benefits of anticoagulation medication while minimizing possible side effects. It’s our way of helping heart disease patients achieve a healthy balance.

Conditions Treated with Anticoagulation Medication Anticoagulation medication may be prescribed for the following conditions:

  • Atrial fibrillation
  • Deep vein thrombosis
  • Pulmonary embolism
  • Valvular heart disease

Your Care Team The Anticoagulation Clinic’s physician director, nurse practitioner and expert nursing staff partner with your physician to effectively manage your medication, whether you’re taking Coumadin (generically known as warfarin or Jantoven) or heparin.

The Anticoagulation Clinic staff provides heart disease patients with:

  • Immediate test results and medication adjustments
  • Reduced wait time for appointments
  • Individualized lifestyle recommendations

Our Location
The Anticoagulation Clinic is located at Miami Cardiac & Vascular Institute at South Miami Hospital’s East Tower, 6701 SW 62 Avenue, and is open Monday-Friday, 8 a.m.-5 p.m.


Heart Rhythm Center

Arrhythmia Treatment

Heartbeats: The Rhythm of Life
It can be upsetting to learn that you have an irregular heartbeat, also known as an arrhythmia. If your arrhythmia is mild, it may not require treatment or cause problems. Sometimes, however, an arrhythmia can interfere with your ability to enjoy life. Symptoms may include weakness, fainting, palpitations and low blood pressure. Miami Cardiac & Vascular Institute understands your concern. In fact, we created the inpatient L. Austin Weeks Center for Cardiac Electrophysiology to address your needs.

L. Austin Weeks Center for Cardiac Electrophysiology

Patients with irregular heartbeats, also known as arrhythmias, benefit greatly from Miami Cardiac & Vascular Institute at South Miami Hospital’s accredited Center for Cardiac Electrophysiology. The Center uses the latest advances to study heart rhythm abnormalities, detect problems and define proper treatments.

Expert Care, Accurate Diagnosis
If you need to be evaluated for arrhythmia, Miami Cardiac & Vascular Institute is the right place to be. Our Center for Cardiac Electrophysiology specialists use the latest methods to evaluate and treat heart rhythm problems. Our cardiac electrophysiologists and specially trained staff provide diagnostic tests, including EKG, complete electrophysiology studies and other monitoring methods. In the case of devices such as pacemakers or defibrillators, electrophysiologists use real-time, three-dimensional images of the heart to look inside the heart chambers. In this way, they can determine if the device is functioning effectively or if adjustments are needed.

Center Services include:

  • Anticoagulation Clinic
  • Women’s heart services
  • Men's heart screenings
  • Vascular screenings
  • Heart failure disease management
  • External Counter Pulsation for angina and heart failure
  • Event monitoring for abnormal heartbeat
  • Educational seminars on heart rhythm disturbances and arrhythmia treatments

The care team at Miami Cardiac & Vascular Institute encourages all patients and family members to learn more about conditions and diseases that affect the heart and overall cardiovascular system. The links below provide more information about heart conditions and diseases that might be treated within this program.

Atrial Fibrillation (AF or AFib)
Normally, the heart pumps in a well-timed fashion. The two upper chambers(atria) contract first, followed by the two lower chambers (ventricles). This coordinated pumping is powered by the heart's own electrical system and efficiently pumps blood out to the body and back. In atrial fibrillation (AF), a type of arrhythmia, the electrical signals fire rapidly and chaotically.

Atrial Flutter
There are many types of abnormal heart rhythms, or arrhythmias. Symptoms range from mild to life-threatening. Atrial flutter is a common type of arrhythmia. Atrial flutter involves the upper chambers of your heart (the atria), rather than the lower chambers (the ventricles). With atrial flutter, your atria beat more quickly than they should. This usually isn’t life- threatening, but it does make it difficult for your heart to pump blood efficiently.

An arrhythmia is an abnormal heart rhythm.

Ventricular Tachycardia
Ventricular tachycardia is a rapid heart rate. It begins in your heart’s lower chambers, or ventricles. Experts usually define ventricular tachycardia as three or more heartbeats in a row, at a rate of more than 120 beats a minute. If ventricular tachycardia lasts for more than a few seconds at a time, it can become life-threatening.

Ventricular Fibrillation
Ventricular fibrillation (V-fib) is a type of arrhythmia, or irregular heartbeat that affects your heart’s ventricles. Your heart is a muscle system that contains four chambers; the two bottom chambers are the ventricles. In a healthy heart, your blood pumps evenly in and out of these chambers, and this keeps blood flowing throughout your body. An arrhythmia that starts in your ventricle is called ventricular fibrillation.


To help in the diagnosis of your irregular heartbeats, your physician may request that you have one or both of the following tests:

  • EKG (electrocardiogram)
  • Cardiac electrophysiology study

The Institute’s commitment to providing you with the best possible care means we also conduct research on the latest devices and other advances to treat irregular heartbeats.

Atrial Fibrillation

Continued Access to PREVAIL (CAP2) WATCHMAN Left Atrial Appendage (LAA) Closure Technique Principal Investigator: Ramon Quesada, M.D. (Active Follow-Up)

Continued Access to Protect AF (CAP)This pivotal study is designed to demonstrate the safety and effectiveness of the WATCHMAN implant in patients with non-valvular paroxysmal, persistent or permanent atrial fibrillation (AF) who require treatment for potential thrombus formation.
Principal Investigator: Ramon Quesada, M.D. (Active Follow-Up)


ICY-AVNRT – Intracardiac CrYoablation for Atrio Ventricular Nodal Reentrant Tachycardia Principal Investigator: Efrain Gonzalez, M.D. (Active Enrollment)

MICRA Transcatheter Pacing – Percutaneous Leadless Pacemaker Clinical Study This study is a prospective, multi-site, single-arm, worldwide Investigational Device Exemption (IDE) clinical study. The purpose of this clinical study is to evaluate the safety and efficacy of the Micra Transcatheter Pacing System and to assess long-term device performance.
Principal Investigator: Efrain Gonzalez, M.D.