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AFib at Heart of Electrophysiology Service

Atrial fibrillation, often called AFib, is one of the most common heart disorders. In fact, it’s estimated that by 2030, 12.1 million people in the U.S. will have AFib, a heart arrhythmia in which the heart either beats too slowly, too fast, or in an irregular way.

That’s why comprehensive preventative cardiac care has never been more important, says Dr. Michael Mazzini, full-time faculty at Massachusetts General Hospital and medical director of the Wentworth-Douglass Hospital Center for Heart Health, with locations in Dover and Portsmouth.

“We now offer more comprehensive care for AFib than many other healthcare organizations,” says Mazzini, a board-certified cardiologist and electrophysiologist. “We have a full-spectrum of testing and treatment options here in the Seacoast.”

In fact, since opening in January 2020, the Wentworth-Douglass Clinical Cardiac Electrophysiology Service is one of only two freestanding full-time electrophysiology programs in metro Boston, with a steady, significant increase in patient volume and referrals, he says.

Considered the “electricians” of the heart, electrophysiologists (EPs) diagnose and treat heart rhythm disorders caused by abnormalities in the heart’s electrical activity. These can occur in people with otherwise normal hearts, or with those with heart problems like cardiomyopathy, congenital heart disease, heart failure, or hereditary conditions.

“Now that we have full-time electrophysiologists, we have cases coming in that before would have gone elsewhere,” Mazzini says. “We can do specialized testing and therapies patients used to have to leave the area for.”

An AFib diagnosis can be elusive, Mazzini says. Some have no symptoms. Others may have symptoms including irregular heartbeat, heart palpitations, lightheadedness, extreme fatigue, shortness of breath, and chest pain.

“AFib can present in a variety of different ways,” Mazzini says. “Someone can be completely asymptomatic and it’s found in a routine exam or they can be highly symptomatic prompting them to go to the ER.”

The most common chief complaint for someone referred to the EP Service is heart palpitations or “an uncomfortable awareness of their heart beating rapidly or in an irregular way.”

“People can be experiencing anxiety, a shortness of breath, their heart flipflopping in their chest,” Mazzini says. “Those are the things that usually lead to people coming to see me.”

The bottom line, he says, “If you feel an uncomfortable sensation in your chest, you should seek medical attention.”

Although those with AFib usually are in their 50s or older, Mazzini has treated patients as young as 18. High blood pressure accounts for about one in five cases. Other risk factors include obesity, high cholesterol, European ancestry, diabetes, heart failure, prolonged usage of alcohol, undiagnosed sleep apnea, smoking, and a sedentary lifestyle. A person with a first-degree relative with AFib also may be at higher risk.

Although men and women are equally at risk for AFib, it’s more common in women, because of their longer life expectancy. In addition, “women with AFib have strokes that tend to be worse and their morbidity and mortality attributed to AFib is higher,” he says.

It’s critical to determine, as early as possible, whether someone has AFib because it is linked to the cause of about one in seven strokes.
Wentworth-Douglass Hospital's EP Service’s testing includes “the latest and greatest 3D mapping system” of the heart, Mazzini says, as well as electrocardiograms (EKG), echocardiography (echo), transesophageal echos (TEE), heart stress tests, Holter event monitoring, loop recorders, tilt table testing and electrophysiology studies (EPS).

Once diagnosed, the EP team, led by renowned MGH EPs, offers extensive non-invasive and invasive treatments. Treatment options include Cardiac Resynchronization Therapy (CRT), using a special cardiac pacemaker to synchronize the heart’s ventricles; Implantable Cardioverter Defibrillators (ICDs); pacemakers; and catheter ablations.

The Wentworth-Douglass clinical team is also able to seamlessly partner with Mass General's team of electrophysiologists and cardiologists.

In addition, Wentworth-Douglass has device clinics in both Dover and Portsmouth for patients with pacemakers, ICDs, biventricular pacemakers/defibrillators (CRT-Ps and CRT-Ds) and implantable loop recorders (ILRs).

“We’re really proud of the work we do,” Mazzini says. “Our Center is a great resource for heart patients in the Seacoast.”

Learn more about the Clinical Cardiac Electrophysiology program at Wentworth Douglass Hospital and the types of cardiac care that we offer.

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