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The Queen’s Medical Center (Punchbowl)
550 South Beretania
Honolulu, Hawaii 96813
Phone:
808-691-8512
Fax:
808-691-8919
Hours:
M-F: 8:00 am – 5:00 pm
Queen’s Center for Heart Rhythm Disorders delivers state-of-the-art care for patients with electrical heart disorders, offering advanced, highly specialized therapies to diagnose and treat a wide range of heart rhythm conditions with precision and expertise
Arrhythmias are disorders of the heart’s electrical system that cause the heart to beat too fast, too slow, or in an irregular pattern. Normally, the heart’s electrical signals coordinate each heartbeat in a steady, organized rhythm. When these signals are disrupted, the result can be palpitations, dizziness, shortness of breath, fatigue, or even fainting.
Arrhythmias range from benign conditions that require monitoring to more serious rhythm disturbances that may increase the risk of stroke or sudden cardiac arrest. Specialized cardiac electrophysiology services focus on diagnosing the exact cause of an abnormal rhythm and providing advanced treatments — including medication management, catheter ablation, implantable devices, and remote monitoring — to restore and maintain a healthy heart rhythm.
Examples of arrhythmias may include:
The team at Queen’s Center for Heart Rhythm Disorders takes a multidisciplinary, patient-centered approach to delivering comprehensive atrial fibrillation care. We believe coordinated, collaborative care is essential to achieving the best possible outcomes in the management of atrial fibrillation. Each treatment plan is thoughtfully tailored to the individual, incorporating the latest evidence-based therapies and advanced technologies to restore and maintain optimal
heart rhythm.
Atrial fibrillation (AFib) is the most common type of sustained heart rhythm disorder in the world. It occurs when the upper chambers of the heart (the atria) beat rapidly and irregularly due to disorganized electrical signals. Instead of contracting in a coordinated way to move blood efficiently into the lower chambers, the atria quiver, which can reduce the heart’s overall efficiency.
AFib may cause symptoms such as palpitations, fatigue, shortness of breath, lightheadedness, or chest discomfort — though some individuals have no symptoms at all. Importantly, atrial fibrillation can increase the risk of stroke and heart failure if left untreated.
Cardiac electrophysiology specialists diagnose AFib using advanced monitoring tools and tailor treatment to each patient. Management may include lifestyle modification, medications to control heart rate or rhythm, stroke-prevention therapies, cardioversion, catheter ablation, or implantable devices — all designed to restore rhythm, relieve symptoms, and reduce long-term risk.
Your multidisciplinary care team may include:
It is estimated that one out of every four individuals will develop AF in their lifetime. Certain risk factors are associated with a greater likelihood of developing AF including:
Symptoms of AF can range from almost non-existent to disabling.
Mild symptoms include:
Severe symptoms include:
Some of the consequences of AF include heart failure and stroke.
AF is usually diagnosed with an electrocardiogram (ECG or EKG), which records the heart’s electrical activity.
Other tests that may be performed:
Fortunately, there are many treatment options for AF, focused around two strategies:
You should discuss with your doctor which treatment plan makes sense for you.
The goals of AF treatment may include:
Patients with AF are 5 to 7 times more likely to have a stroke.
Strokes in AF patients occur when a blood clot, caused by blood pooling when the top chambers of the heart (atria) beat rapidly, is dislodged from the heart and travels to the brain. Approximately 90% of these clots are formed within the area of the heart known as the left atrial appendage.
An individual’s risk of stroke due to AF is dependent on many factors, such as:
To assist with stroke prevention, many patients will be prescribed medication called anticoagulation therapy. For patients who are at a high risk of bleeding or cannot tolerate anticoagulation therapy, they may be eligible to have a non-surgical procedure called a Left Atrial Appendage Occlusion.
Ablation therapy is a minimally invasive procedure used to treat abnormal heart rhythms (arrhythmias) by targeting the small areas of heart tissue responsible for disrupted electrical signals.
During a catheter ablation, a cardiac electrophysiologist guides thin, flexible tubes (catheters) through blood vessels to the heart. Using advanced mapping technology, the precise source of the abnormal rhythm is identified. Energy — pulse field (high-energy electrical pulses), radiofrequency (heat) or cryotherapy (cold) — is then delivered to create small, controlled scars that block or eliminate the faulty electrical pathways. Ablation therapy is designed to restore a normal heart rhythm, reduce symptoms, and in many cases decrease the need for long-term medications. For many patients, it offers a safe and effective treatment option with shorter recovery times compared to traditional surgery.
Currently, the Queen’s Center for Heart Rhythm Disorders offers radiofrequency (thermal) or pulse field ablation. The type of ablation therapy used is determined by the electrophysiologist and is dependent on what type of arrhythmia is being treated.
Ablation therapy is available for many arrhythmias, including:
Many patients are able to go home a few hours after the procedure is finished. On occasion, some patients may require an overnight stay in the hospital.
Left Atrial Appendage Occlusion (LAAO) is a procedure that Queen’s Center for Heart Rhythm Disorders offers to patients with atrial fibrillation (AFib) who are at high risk for stroke, but are unable to take blood thinners. Because approximately 90% of blood clots in AFib form in the left atrial appendage, occluding (or blocking) it may reduce stroke risk.
The team at Queen’s Center for Heart Rhythm Disorders utilizes the WATCHMAN™ device. This device is a minimally invasive, catheter-based implant designed to reduce stroke risk in patients with non-valvular atrial fibrillation (AFib) who are unable to tolerate long-term blood thinners or prefer an alternative to lifelong anticoagulation. The WATCHMAN device is placed through a catheter inserted in a vein in the leg and guided into the heart, where it permanently seals off the left atrial appendage to prevent clot formation in this area.
Over time, heart tissue grows over the device, creating a lasting barrier. For many patients, the WATCHMAN procedure offers an effective, one-time solution to reduce stroke risk while minimizing or eliminating the need for long-term anticoagulant medications.
Before having the device implanted, patients undergo imaging of the heart through either a Transesophageal Echocardiogram (TEE) or a cardiac CT scan to assess the heart’s anatomy and to ensure a clot is not present.
The procedure is typically done under general anesthesia. An electrophysiologist or
interventional cardiologist will implant the device into the left atrial appendage under imaging guidance with TEE or intracardiac echocardiography and fluoroscopy.
It is not unusual for patients to be admitted overnight after the procedure, however, some have been able to go home the same day. Post procedure patients are kept on either anticoagulation therapy plus Aspirin or dual antiplatelet therapy (ie Aspirin and Clopidogrel) for a period of time. The medications are stopped or changed at subsequent follow-ups depending on test results. Repeat imaging of the heart is performed around 45 days post procedure and again 1 year post procedure.
You are a good candidate for LAAO if you have AF with a high risk for stroke and:
To learn more, call the Queen’s Heart Institute Center for Heart Rhythm Disorders at 808-691-8512.
Cardiac Implantable Electronic Devices (CIEDs) are implanted to monitor for abnormal heart rhythms, regulate slow heart rhythms, prevent dangerous arrhythmias, and support overall heart function. They help maintain a steady heartbeat, reduce symptoms like dizziness or fainting, and lower the risk of serious complications, including sudden cardiac arrest.
The Device Clinic at Queen’s Heart believes in continuity of care from the time that your doctor recommends implantation of a cardiac device. In addition to regularly scheduled clinic visits, you may be enrolled in our remote monitoring program, which allows our physicians and other device clinic staff to be alerted quickly if there is a problem with your device or with your heath rhythm.
Our comprehensive Cardiac Implantable Electronic Device (CIED) management program provides expert monitoring, optimization, and long-term care for patients with implantable loop recorders (ILRs), pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices to ensure optimal device performance and heart health.
Cardiac implantable electronic devices (CIEDs) may be implanted as a transvenous,
subcutaneous, or leadless device. Transvenous devices use leads threaded through veins into the heart to provide pacing or defibrillation. Subcutaneous ICDs sit under the skin without touching the heart or veins, providing defibrillation for life-threatening arrhythmias while minimizing vascular complications. Leadless pacemakers are self-contained units implanted directly in the heart, eliminating the need for leads. The type of device implanted is determined by the electrophysiologist after taking specific patient factors into consideration. The Queen’s Center for Heart Rhythm Disorders offers all of these devices.
Most CIEDs come with a remote monitor, this may also be referred to as home monitoring. Remote monitoring allows our electrophysiology team to securely track your cardiac implantable electronic device (CIED) from the comfort of your home. Using a bedside or wireless transmitter, your device sends encrypted data directly to our clinic for regular review.
This technology enables early detection of abnormal heart rhythms, device alerts, battery status changes, and signs of fluid retention or heart failure. By identifying potential concerns promptly, we can intervene earlier — often before symptoms develop — reducing the need for in-person visits and helping prevent hospitalizations.
Remote monitoring enhances safety, improves convenience, and ensures continuous, proactive management of your heart rhythm and device performance.
Our team works with a trusted third-party remote monitoring vendor to support timely data transmission, reporting, and care coordination.
Lead extraction is a specialized procedure performed to safely remove one or more leads (wires) from a cardiac implantable electronic device (CIED) such as a pacemaker, implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy (CRT) device. Leads may need to be removed due to infection, malfunction, damage, or when upgrading to a newer device.
Lead extraction requires specialized expertise and is performed by a multidisciplinary team to ensure patient safety and optimal outcomes. Using advanced tools and techniques, the lead(s) are carefully detached from the heart and blood vessels while minimizing risk to surrounding tissue. Procedures are performed in a controlled hospital setting with full cardiac support available if needed.
Key benefits of lead extraction include:
Currently, the Queen’s Center for Heart Rhythm Disorders has the only lead extraction program in the state of Hawaii.
To learn more about Queen’s Center for Heart Rhythm Disorders, or to schedule an appointment, call 808-691-8900.
Hours of Operation: Monday through Friday, 8:00 am to 5:00 pm
Located at Queen’s Heart Institute at Physicians Office Building 3 (POB 3) Suite 610.
