For almost 20 years, Schenectady resident Dave Connelly had dealt with heart problems, but he now has a regular heart rate — admittedly, feeling “normal” felt odd at first.
“At first it was a little tough to get used to,” Connelly said. “Now I can feel the old age stuff, because I am not worried about the other stuff right now.”
Connelly, 62, said he ignored his symptoms for several years before seeking medical treatment for what he thought was just a gastric issue. He described a symptom as feeling like he had butterflies in his stomach. Once the feeling started to occur more frequently he knew something was wrong.
After a series of tests in 1998, he was diagnosed with atrial fibrillation, or a-fib, which is an irregular and often rapid heart rate that typically leads to poor blood flow throughout one’s body. A-fib is a common cardiac arrhythmias that can increase the of risk of stroke, and around 5 million people are afflicted.
In December, Connelly became the first patient to undergo the hybrid ablation procedure at Ellis Hospital in Schenectady. The two physicians performing the procedure on Connelly, Dr. Herbert Reich and Dr. Robert Joy, along with two other Ellis physicians, discussed the heart care advancement during “A Meeting of the Minds” informational event on Thursday, March 8, at the Hilton Garden in Clifton Park.
An electrophysiologist and a cardiothoracic surgeon work together to perform a hybrid ablation procedure. Cardiothoracic Surgeon Reich created scar tissue on the outside of Connelly’s heart, while Electrophysiologist Joy used a catheter to create scar tissue inside the heart. The scar tissue helps restore normal heart rhythm by blocking damaged electrical pathways causing the irregular heartbeat.
“I work from the outside in and he works from the inside out,” Reich said.
Reich, a Niskayuna resident, said a benefit of the procedure is that it’s minimally invasive, requiring him to make a 1-inch incision in the abdomen. The device he uses is 3 centimeters in length and he uses it to complete around 80 percent of the work, before Joy does his share.
Besides the benefit of being minimally invasive, he said theoretically there is a high, long-term success rate.
“It can take a long time. It can need a second, third or rarely a fourth procedure to get it to set and you have to meet certain criteria,” Reich said. “Hopefully it is done in a more efficient manner time wise so it is less anesthesia for the patient.”
Often, such as with Connelly, Reich said patients are on medications to control irregular heartbeats.
“Most of the time the patients are on medications to control the heart rate and heart rhythm … medications are costly and have side effects,” Reich said. “The need to take several drugs, plus the side effects, plus the cost, kind of adds up on some of these people. Even with all the medicines some patient still don’t tolerate being in atrial fibrillation well — they feel it.”
When diagnosed, Connelly said he used medication and adjusted the dosage level for around four years. He continued using the medication for around 12 years until it didn’t work effectively anymore.
“That kept things under control, I was having instances of a-fib over that period of time, but it would be once to twice a year and the episodes would last anywhere from half-an-hour to two or three hours,” Connelly said.
His doctor tried using a different medication, but continued to have episodes on a daily basis, which he said felt like “a runaway train in his chest.” Episodes at night would even wake him up out of a sound sleep, with symptoms sometimes lasting up to 19 hours.
“I could function generally, but it depended how intense the episodes were,” he said, “sometimes the episodes would be so intense that I was extremely irritable and then you wouldn’t want to deal with me.”
After a week trying the new medication, Joy talked to him about the newly offered procedure.
Since the Dec. 19 procedure he said he hasn’t had any real episodes, which is one less thing he has to worry about since it could happen at any time. The longer he doesn’t have an episode, the more likely long-term relief will be realized.
The only medication he is on now is a blood thinner, which is planned to be short term.
“I’d like to say I am drug free, but I am still on a blood thinner as a precautionary thing,” he said. “I feel good — I feel better.”
His resting heart rate now falls within the normal range, at 70 to 80 beats per minute. Before the procedure, his heart rate was kept artificially low at about 50 to 60 beats per minute.
“It is kind of a nice thing,” he said.
Good candidates for the procedure are patients with more persistent a-fib or have other conditions, such as abnormally large hearts, that might not achieve the same benefits from catheter-only based procedure. There also have been few minimally invasive treatment options for these patients previously, which also involved longer recoveries and increased risks.
“Any time you have something that can improve the patients’ life, lifestyle, make them feel better and get them out of the medical risks of stroking and needing medications … it is a win for everybody,” Reich said.
To learn more about the hybrid surgical-catheter procedure for chronic atrial fibrillation, call Ellis at 243-3610.
