Experimental surgery improves life for Palatine 80-year-old

On Barbara Ganschow's coffee table lies a small stone inscribed with an appropriate phrase: "Women who behave never make history."

Had the 80-year-old Palatine woman been entirely forthcoming with her family, they may not have allowed her to undergo a heart procedure dependent on a device never before used on a human.

"My daughter-in-law was worried enough already," said Ganschow. "They didn't need to know what was going on."

On June 16, doctors at the University of Chicago Medical Center operated on Ganschow, who five years ago was diagnosed with atrial fibrillation after finding herself unable to walk straight at the Johannesburg, South Africa, airport.

Subsequent episodes of the irregular, overly rapid heart rate made her confused, dizzy and sometimes so weak her legs would give out.

"I just didn't leave the house when I was in a-fib," she said.

Ganschow had spent the last three years symptom-free thanks to a procedure known as catheter ablation, which destroys abnormal electrical pathways in the heart. But when the arrhythmia returned earlier this year, scar tissue and thickening of the atrial septum (the thin wall of muscular tissue separating the heart's upper chambers) prevented doctors from entering the heart via traditional methods to perform the same procedure.

Medication proved ineffective in the past, so the likely alternative, Ganschow said, was to "pretty much just live with it. I wasn't thrilled."

But Ganschow's specialist, Dr. Raymond Kawasaki at Good Shepherd Hospital in Barrington, got wind of a device that received FDA approval just a few weeks earlier. Dr. Bradley Knight, the University of Chicago's director of cardiac electrophysiology, could get his hands on it.

Knight used the new NRG Transseptal Needle, made by Montreal-based Baylis Medical, to burn a small hole into Ganschow's atrial septum. That opened access into the heart's left upper chamber and enabled the ablation to proceed. The needle uses radio-frequency energy - the same intense radio waves that heat TV dinners in the microwave.

Knight said 5 percent of people Ganschow's age have atrial fibrillation, though only a small percentage require ablation. Definitive studies are sparse, but surveys of electrophysiologists suggest nearly 15 percent of that group need a second procedure, putting them in the same boat as Ganschow, says Baylis spokesman Ramsey Leung.

Repeat procedures are risky because surgeons have to use their own pressure to push a stainless steel needle through a septum that can be enveloped in scar tissue and either very thick, fibrotic or even elastic. The conditions increase the chances of the needle accidentally perforating the heart.

"It's a concern because it can be difficult to pass a needle through," said Knight. "In (Ganschow's case), we turned the radio-frequency on and (the Baylis device) went right into the left atrium. One try, very easy."

Baylis sees its NRG Transseptal Needle, the first of its kind on the market, as becoming a new standard of care that could eventually make the old needle obsolete. The company is on the verge of signing a distribution deal that would put the device in the hands of more specialists, Leung said.

"Speaking to us at medical conferences, many doctors have expressed to us their intention to switch over completely to the NRG Needle," Leung said.

The traditional procedure is already expensive. The University of Chicago estimates the cost to a patient with private insurance is $40,000. Baylis is still finalizing the pricing for the new needle, but the cost will be higher - at least initially - because it requires a separate generator.

The idea she'd be the first person in the world to be treated with the new needle, which essentially causes a cell to burst by boiling off its water, didn't concern Ganschow.

"I had no reservation whatsoever," she said. "My only worry was whether it would work."

In fact, Ganschow thought it made for a fun story. She even convinced doctors to push back the surgery until after her June 10 birthday so she could reach octogenarian status.

"I just thought 80 had a better ring to it," she said.

Knight doesn't see the new needle as revolutionary, despite the prospect that more people like Ganschow may not have to live with the incapacitating disease.

Still, he says, "In a few years, hopefully we'll look back and think how silly it was the way we were poking needles through like that."

Now that she's recovered from the surgery, Ganschow, who's widowed with two children and two grandchildren, hopes to travel again. Her favorite destination is the Middle East, where she's visited Israel, Turkey, Syria and Jordan.

And, she adds, "I'm just looking forward to having a normal life where I don't have to pretend to tie my shoes in a store because I'm getting dizzy and need to put my head down."