Advancing Electrophysiology: Success at the James H. Quillen VA Medical Center
By Daniel Ackerman, Acting PAO
The James H. Quillen VA Medical Center (JHQVAMC) has become a pioneer within the Veterans Health Administration by becoming only the second VA Medical Center to perform complex atrial fibrillation ablations without an on-site Cardiothoracic Surgery unit.
This significant achievement marks a milestone in providing advanced cardiac care, particularly for patients suffering from tachy-arrhythmias, a group of conditions characterized by abnormally fast heart rates. Atrial fibrillation, a common type of tachy-arrhythmia, is notably associated with an increased risk of stroke, yet there are numerous other tachy-arrhythmias that can cause debilitating symptoms, strokes, and heart failure.
At JHQVAMC, three primary methods are utilized for catheter ablation to treat abnormal heart rhythms:
Radiofrequency Ablation - This method employs a catheter to deliver heat and destroy the specific area of heart tissue responsible for the abnormal rhythm.
Cryothermal Ablation - Similar in approach to radiofrequency ablation, this method uses cold temperatures to freeze and eliminate the aberrant tissue.
Pulsed Field Ablation - Utilizing short bursts of energy, this technique targets and eradicates the abnormal tissue with precision.
The cardiology team’s journey to establish an invasive electrophysiology ablation program began with exhaustive planning and a thorough review process, including site visits from the National VA Cardiology Team. Initial approval for low-risk, non-complex ablations was granted in April 2024. Since then, the team at JHQVAMC has successfully performed 84 ablations without complications, demonstrating their expertise and commitment to patient safety.
Recognizing their success, the team sought and gained expanded approval in the Spring of 2025 to perform unrestricted complex ablations. This led to a landmark event on July 17, 2025, when JHQVAMC successfully performed its first complex atrial fibrillation ablation, again without complications.
The electrophysiology lab at JHQVAMC is equipped with the latest state-of-the-art diagnostic and interventional equipment, providing a safe and cost-effective alternative to patients who previously had to navigate long wait times for community care. The establishment and accomplishments of the lab are overseen by Dr. Michael Donovan, DO, FACC, FACP, CCDS, who serves as the Chief of Cardiology and Director of the Cardiac Catheterization Lab. The procedures are performed by Dr. James Merrill, MD, and his dedicated team Laura Barton, RN, Noah Claman, RN, Justin Farrey, RN, Jarrett Hill, RN, Carrie Kiersnowski, RN, Brandon Koski, RN, Emily Lundy, RN, Bobby Morton, RN, David Woodby, RN, and Mike Clark, RCIS (Cardiac Catheterization Team) and also special recognition to Patrick Belisle, RN (scheduler/case manager) Lesley Mackley, RN (educator) and Lauren Misciagna, RN (device nurse).
Patients undergo a stringent screening process to assess safety profiles and identify potential risks, ensuring the best possible outcomes. An intricate cardiac CT and imaging map facilitate accurate ablation targeting, offering precise treatment. Most non-complex cases are completed as same-day procedures, while complex cases typically require overnight observation and discharge.
The dedication and innovation demonstrated by the JHQVAMC cardiology team highlight their commitment to advancing cardiac care for Veterans, ensuring that they receive the highest standard of treatment close to home.