Butler Health System | Health Link | Winter 2022

BHS HEART TEAM Get your heart back in rhythm Call 833-995-0118 to schedule an appointment with a Butler Health System electrophysiologist, and learn more about the procedures we offer a t BHSElectrophysiology.org . Donald Bullman is an active guy. When he’s not working on his rental properties, you might find him cycling, walking or playing pickleball. In other words, Donald has a lot of living to do. So when atrial fibrillation (AFib) began to limit his daily life, Donald started to look into treatment options. Ultimately, he had a specialized convergent cardiac procedure at BHS that he says has led to a 180-degree turn in his life. “I get up every day feeling great,” Donald says. “I don’t wake up at night anymore. I’m not light- headed or dizzy. I’m not fatigued. It has made a world of difference in what I can do and in my quality of life.” Living with chronic AFib Donald was diagnosed with AFib about eight years ago. The condition—an irregular heart rhythm trig- gered by abnormal electrical signals in the heart—can cause disruptive symptoms and serious complications. Before his diagnosis, Donald didn’t have any symptoms of AFib, such as fatigue, shortness of breath, dizziness or fluttering heartbeats. But one day his wife found him passed out on their living room floor. Doctors administered IV medications that restored the normal rhythm to Donald’s heart. A few years later, however, his AFib returned. Donald then had a catheter ablation procedure. That’s when specialists use radiofrequency (RF) energy or extremely cold temperatures (cryoablation) to scar abnormal heart tissue without harming the heart. Like insulators, the scars block abnormal electrical pathways in the heart that cause irregular beats. But in December 2020, Donald’s AFib again returned—“with a vengeance,” he says. Often, he felt dizzy and light-headed and couldn’t sleep because of his racing heart. He was tired all the time. “I didn’t want to have to live my life feeling like this every day,” he says. “So I asked my cardiologists about my options, and I started to do research.” His research and his cardiologists’ recommen- dation led Donald to BHS and James Storey, MD, FACC, FHRS, an electrophysiologist at BHS Cardiac Electrophysiology. Another option After meeting with Dr. Storey, Donald learned he was a candidate for a type of ablation called a convergent procedure. Standard ablation (done with a cathether placed inside the heart) is an effective treatment for many people with early-stage AFib. But to help correct their arrhythmias, some people with advanced, persistent AFib require more areas of the heart to be treated with combined surgery and catheter abla- tion. That’s the convergent procedure. First, cardiothoracic surgeon George P. Davliakos, MD, of BHS Cardiothoracic Surgery, put a lighted scope through a 1- to 2-inch cut in the lower part of Donald’s chest. Dr. Davliakos then used RF energy to cauterize targeted areas on the back, outer wall of Donald’s heart, from which abnormal electrical signals spread. The second part of the procedure occurs four to six weeks later. Dr. Storey put a catheter into a vein in Donald’s groin and advanced this wire up to the left upper chamber of the heart. He then used cryoabla- tion to treat more areas of abnormal heart tissue. A high success rate The convergent procedure has been shown to reduce AFib episodes by more than 90% in 75% of patients. Patients also have fewer symptoms and need fewer medicines to control their AFib. In a 2020 study, success rates for the convergent procedure were nearly 70%, compared to 50% for ablation alone. What makes the procedure so effective? The addition of surgery allows better and safer access to areas of the heart that are difficult to reach with catheter ablation alone. Notably, it combines the expertise of both an EP doctor (specialists in heart- rhythm problems) and a cardiothoracic surgeon. But it isn’t for everyone. Good candidates may include people with long-standing AFib or recurrent symptoms despite a previous ablation from inside the heart. “It is part of the spectrum of care for patients with AFib,” Dr. Davliakos says. “This adds another option for those who have been difficult to treat in the past.” According to Dr. Storey, “the convergent proce- dure is a nice example of how two different cardiac specialists, an electrophysiologist and a cardiac surgeon, can collaborate to offer patients a safer and more effective procedure.” A reboot of life Donald feels like a new man. His research into treat- ment options paid off. “I feel like a million dollars,” he says. He has also made heart-healthy changes, such as improving his diet, losing excess weight and lower- ing his blood pressure. “I wake up every day feeling blessed,” he says. Specialized procedure reversed a chronic irregular heartbeat George P. Davliakos, MD Cardiothoracic Surgery James Storey, MD, FACC, FHRS Electrophysiology Getting back to the rhythm of life Donald Bullman has a heart-to-heart with Dr. Storey after his procedure. HEALTH LINK 6 |