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Curing Erratic Hearts
Atrial fibrillation sufferers applaud new mini-maze option for racing hearts
By Janice Youngwith
Wednesday, February 6, 2008
There's good news on the heart front, especially for Dave Theel, a 47-year-old carpenter and the nearly three million other Americans who experience erratic, racing hearts each year.
Theel is something of a trailblazer when it comes to matters of the heart. He was the first patient to undergo a new form of heart surgery that doctors say cured his erratic heart spells.
"I was told I'd be the first, and was a bit apprehensive," Theel recalls. "But the alternative meant I'd continue to have significant heart pain and pass out when my heart raced. After several emergency calls to 911, ambulance transport to area hospitals, mini strokes and pseudo seizures, I decided it was time to act."
A viable option for atrial fibrillation
Offered at less than 100 hospitals across the nation, a new mini-maze procedure is being extolled as a viable option to cure atrial fibrillation, a condition causing the heart's two small upper chambers to quiver instead of beating effectively.
Atrial fibrillation, according to the American Heart Association, is widely known as the most common, sustained cardiac arrhythmia. Atrial fibrillation affects an estimated 2.2 million patients in the U.S. with approximately 300,000 new cases diagnosed per year. It is predicted that 5.6 million patients will be diagnosed with atrial fibrillation by the year 2050.
Because blood isn't pumped completely out of the heart when patients experience artial fibrillation, it may pool and clot, increasing the risk for stroke. Nearly 15 to 20 percent of strokes occur in people with atrial fibrillation.
For Theel and others, medications to slow the rapid heart rates and blood thinning medicines to reduce the risk of stroke are among the first line of defense doctors recommend. Electrical cardioversion may be used to restore normal heart rhythms with an electrical shock when medications fail to restore normal rhythm. In addition, radiofrequency ablation delivering a burst of radiofrequency energy to destroy tissues triggering abnormal electrical signals or block abnormal pathways may be employed.
Other options include the use implantable pacemakers to help regulate heart rhythm and major open heart surgery to disrupt electrical pathways generating atrial fibrillation.
"Yet, none of these techniques are considered a cure," says Theel, who applauds the minimally invasive technique, speedy recovery and reduced hospital stay that enabled him to return to carpentry work in just a few days and ride his beloved motorcycle.
'Episodes left me exhausted'
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| Bob Tompkins of Elk Grove was among the first to have the new surgical procedure treating his atrial fibrillation. |
For Bob Tompkins, a 67-year-old retired print sales representative from Elk Grove, the mini-maze results couldn't be any more exciting.
Tompkins says he attributes his initial atrial fibrillation problems of the past year to increased stress and anxiety.
"I'm a worrier," he admits. "During a routine checkup, the doctor noted my heart racing at 187 beats per minute. I was sent right to the emergency room. Cardioversion help to restore normal heart rhythm for short time, but the racing recurred. Drugs were prescribed to help regulate my heart. Ongoing atrial fibrillation episodes left me exhausted and meant the need for a two hour nap every day."
Tompkins says he is buoyed by results of his Oct. 3 mini-maze procedure and hopes to begin a formal exercise program soon.
"Developed by Randall K. Wolf, M.D., in 2003, the new and innovative technique offers great future potential," says Dr. Deemy Rekkas, a board-certified cardiovascular/thoracic surgeon specializing in video assist thorascopic procedures. Rekkas and Wolf collaborated on the first Wolf mini-maze procedures at Alexian Brothers Medical Center, Elk Grove.
A beating heart surgery
Developed by Wolf, a professor of cardiothoracic surgery and director of University of Cincinnati's Center for Surgical Innovation, the technique requires surgeons to use special instruments Wolf helped design. The Wolf Mini-Maze procedure combines an "ablation" method and the "maze" procedure, without performing traditional open heart surgery.
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| Dr. Deemy Rekkas |
"Until recently, surgical treatment for atrial fibrillation meant a highly involved and risky open-chest operation," explains Rekkas who has performed seven mini-maze procedures in the last six months and is the only female surgeon in the world performing the new technique. "The procedure is referred to as beating heart surgery and requires no heart or lung machine."
Instead, Rekkas says, surgeons operate on the pulmonary veins through three tiny incisions in the sides of the chest. "The pulmonary veins are trigger sites for atrial fibrillation, she explains. "I isolate the pulmonary veins and perform a radiofrequency ablation or controlled burn, effectively zapping these trigger sites. A special pen allows me to also test other sites, checking for problem areas using established map guides."
Rekkas notes that at the time of surgery, she also removes a left appendage site where blood frequently pools and clots form."Otherwise," she adds, "when heartbeat is restored, it's not uncommon for these clots to move and cause patients to stroke."
'Results are encouraging'
The mini-maze procedure is a relative new offering that remains a work in progress, says Dr. Hemal Nayak, medical director of electrophysiology and a heart rhythm specialist at Alexian Brothers Medical Center.
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| Dr. Hemal Nayak |
"We still have a lot to learn, but results are encouraging," he notes. "With the growing number of baby boomers now reaching 65, we expect the incidence of atrial fibrillation to increase."
Dr. Nayak explains that the ideal candidate for the mini-maze procedure is a adult with symptoms such as shortness of breath and an erratic racing heartbeat that tends to come and go. "Many patients may find they can't tolerate blood thinning medications due to bleeding or bruising, others may seek answers when anti-arrhythmic medications fail to work over time," he notes.
"Most patients are free of other significant coronary disease, having only a primary electrical problem."
For more information on atrial fibrillation and other cardiac disorders, contact the American Heart Association at (312) 346-4675 or visit www.AmericanHeart.org.
To speak with Drs. Rekkas or Nayak, call the Alexian Brothers Medical Center Cardiovascular Institute at (847) 981-2055.
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