Evolving Role of the Atrial Fibrillation Program Coordinator

Interview With Eileen McMillin, BSN, RN

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EP LAB DIGEST. 2025;25(2):21-22.

Interview by Jodie Elrod

In this interview, EP Lab Digest speaks with Eileen McMillin, BSN, RN, Atrial Fibrillation (AF) Program Coordinator at Piedmont Healthcare - Piedmont Heart Institute - Electrophysiology in Atlanta, Georgia, about the role of the AF coordinator, including patient care, patient education, and more.

When did you begin your role as AF coordinator at Piedmont? 

The AF coordinator role is relatively new in the electrophysiology (EP) field, and typical responsibilities of the role can vary widely according to the needs of the EP practice. I started as the AF coordinator at Piedmont Heart Institute in March 2023. I have held the AF coordinator position for 2 years and have had the opportunity to mold the position over time, helping to grow the AF program with the help and guidance of our 12 electrophysiologists. 

Tell us about Piedmont’s AF Program. 

The AF Program at Piedmont Heart Institute was started in 2019 by Michael Hoosien, MD, director of the program. We currently have a dedicated nurse practitioner who works specifically with our AF population, and a second advanced practice provider will soon be added to the team to accommodate the growing AF population. Approximately 800 patients are referred to our program annually, with the number growing by about 100 every year. The goal for having a dedicated program is to quickly bring our patients in for testing, monitoring, and treatment. Our team offers a multitude of treatment options for AF, including thermal (radiofrequency and cryoablation) and nonthermal (pulsed field) ablation modalities. Other AF treatment procedures include left atrial appendage occlusion, pacemaker implants, antiarrhythmic drug management, and cardioversion. The number of AF ablations at our center continues to increase. In 2022, we performed 810 AF ablations, and in 2024 that number rose to 1560. 

Discuss when the role of the AF coordinator was created at Piedmont, and why.

The need for an AF coordinator was apparent at the inception of the AF program. Given the ever-increasing volume of patients with AF, we understood that the success of the program would require a dedicated coordinator, and therefore, the recruitment process was initiated as soon as we had buy-in from our heart institute. 

Discuss a typical day for you. What challenges do you typically come across? 

My role is to ensure seamless patient care and program efficiency. Each day begins by reviewing referrals from the previous day, assessing patient charts, and coordinating timely appointment scheduling to ensure prompt care. 

One of the previous challenges we faced was that patients were sometimes slipping through the cracks and not being seen. To help combat this, I gather a report each month for our scheduling team to help get our referrals seen in the AF Clinic. I frequently collaborate with medical representatives to organize staff education sessions on the latest medications and procedural devices. On a quarterly basis, I gather and analyze data on the volume of procedures performed by our physicians, contributing to program assessment and improvement for the AF clinic. Additionally, I author a monthly newsletter featuring staffing updates, procedural insights, and safety stories to keep the team informed and aligned. 

However, one of the biggest challenges I encountered as AF coordinator was patient education. This has included creating and revising patient education materials. After working in bedside nursing for 10 years, it was clear that all our patients and families had different learning needs. In this role, I have created a patient education booklet, redesigned the AF program’s website, and created educational videos with our physicians. After coming to see one of our providers in the office, patients and their caregivers now have access to additional information, helping them become more knowledgeable about their AF diagnosis. Additionally, I help to gather data for our team so they are able to assess the progress of the AF Clinic, and watch for areas of quality improvement and patient satisfaction. 

Discuss a typical treatment pathway at the Piedmont Heart Institute for patients with AF, including risk factor modification initiatives and follow-up care. How have treatment pathways become more streamlined over the years? 

We strive to get patients seen through the AF clinic within 2 weeks of being referred. If we are unsure about a patient having AF, a monitor is ordered to assess AF burden. After the initial clinical assessment, rate and rhythm control strategies are discussed, education on stroke prevention is provided, and the patient’s lifestyle is reviewed and adjustments/recommendations are made where appropriate. 

We have seen the largest impact through the emergency department (ED) and our protocol developed with the ED physicians to help create a decision-making pathway aimed at providing efficient, evidence-based care for AF patients. The ED pathway provides guidance in starting a workup for an AF patient, with the primary goal being symptom control and stroke risk reduction. The guidelines for anticoagulation, cardioversion, and ED discharge are outlined in the protocol. This pathway has led to fewer hospital admissions without compromising patient safety, leading to cost savings and more targeted care. 

In addition to working with the ED, we also have built relationships with sleep medicine, exercise medicine, nutrition, and the women’s heart program at Piedmont Heart Institute. 

How does the role of the AF coordinator help shape and grow the EP program and AF clinic?

Currently, my largest responsibility is helping to establish and plan the first EP Summit at Piedmont Healthcare. As the AF coordinator, I can help shape and grow the program by working with this ever-growing disease population, tackling any patient and staff issues, and helping our clinic function at its highest level. 

What tips and practical advice in this role can you provide?

One critical element necessary for the success of a program such as ours is buy-in from external parties. This includes general cardiologists, hospital departments and administrators, ED providers, advanced practice providers, and internal medicine physicians. Demonstrating the benefits of an AF program is a critical first step before launching the program.