Cryoablation: New Hope for a Heart Out of Sync

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Jon Zimmerman

Imagine you are speaking to a large audience when your heart suddenly starts fluttering and racing. You have to finish your talk without letting anyone know about the symptoms you are experiencing. Sounds like a nightmare, but this was Jon Zimmerman’s reality.

Despite these symptoms, Jon continued his grueling speaking schedule for 10 months, hoping the irregular heartbeats (arrhythmia) would stop. But they didn’t. Jon realized he had two choices: he could quit his profession or find a way to stop the arrhythmia.

First, he saw a cardiologist at another medical center but was dissatisfied with the impersonal approach. He didn’t believe he was getting the attention he needed. Then, a friend of his wife suggested he get an appointment with Virginia Mason cardiologist and electrophysiologist Christopher Fellows, MD, FACC, FHRS.

Dr. Fellows and Virginia Mason’s electrophysiology team are a regional referral center for the Pacific Northwest, and perform more than 1,800 electrophysiology tests and ablations (to correct irregular heart rhythms) a year.

“At that first visit with Dr. Fellows, I knew I was in the right hands,” Jon recalls. “Dr. Fellows was very focused on me. He asked all the right questions about my history and how I was feeling. I knew I was with a top-notch professional.”

To achieve an exact diagnosis, Jon was given a physical exam to check his pulse, blood pressure and lungs; an EKG (electrocardiogram) to record the electric impulses of his heart; a stress test to monitor his heart during exercise; a chest X-ray to view the heart and lungs; and a blood test to check for thyroid and metabolic conditions.

When the results were analyzed, it was determined Jon had an atrial flutter, which occurs when the upper chambers of the heart beat too quickly and are out of sync with the lower chambers (ventricles). He also had atrial fibrillation (AFib), when the four chambers of the heart contract at different speeds because of faulty electrical signaling.

Dr. Fellows prescribed cryoablation to restore the normal heart rhythm. During the procedure, a balloon catheter was inserted into a blood vessel in the upper leg. Using advanced imaging techniques, Dr. Fellows then threaded it though Jon’s body until it reached the heart and the inflatable balloon on the end reached the pulmonary vein.

When the balloon was at the opening of the pulmonary vein, extremely cold energy was directed through the catheter to freeze a small amount of tissue at the opening of the vein. This blocks the electrical signals that caused the AFib and restores a healthy heart rhythm.

“We have found that using cold, instead of heat, for cardiac ablation increases the chance of success and decreases the risk of serious complication,” Dr. Fellows says, adding, “Recent studies have found cryoablation to be significantly more effective than medication, and patients generally experience less pain than with radiofrequency ablation.”

“I was symptom-free as soon as the procedure was completed,” Jon states. “Dr. Fellows gave me my life back. I’m traveling and making presentations. My wife and I are able to enjoy hiking and riding our bikes again. This hospital is where miracles happen.”

Jon’s annual aftercare is with cardiologist Gordon Kritzer, MD, FACC. “The handoff was perfection personified, which added to my confidence,” he adds. “I see Dr. Kritzer every year now.”

Jon gives the attention he received at Virginia Mason high marks. “Not just those who provided and supported my care, but also the team members who communicated with me clearly so I knew what I needed to do and what to expect. They all are world-class.”


A version of this story also appears in the Virginia Mason Health System Annual Report.

A Heart Back in Rhythm: Dominik’s Story

Dominik

Dominik Musafia

Prior to his recent experience at Virginia Mason, Dominik Musafia, 47, was “a skeptic of modern medicine.” That’s why it took him a while to see a doctor when he was having health problems.

A divorce attorney, Dominik is used to stress and fatigue from working long hours. But in the summer of 2013, he noticed that he was more than just a little tired. At a July 4th gathering, he was finding it difficult to play Frisbee with friends. His friends insisted he see a doctor, which he reluctantly did.

That physician, a cardiologist, found that Dominik was having premature atrial contractions (PACs), but said that there was absolutely nothing for him to be concerned about. “After stress testing, he told me I had the cardiovascular system of a 27-year-old,” remembers Dominik, who still felt something wasn’t quite right.

About six months later, Dominik’s heart converted into persistent atrial fibrillation or AFib, a condition often characterized by an irregular and rapid heart rate. By itself, AFib is not considered life-threatening. However, if left untreated, it can increase the risk of stroke, heart failure and complications such as blood clots.

“I thought, ‘well, I’ve been to a cardiologist and I’m told I need to live with it,'” says Dominik. “Also, I really didn’t have time to deal with it.” After a while, however, Dominik’s heart health started deteriorating and he was having difficulty doing “ordinary” things like walking up the steps in his house. He took a friend’s advice to see a cardiologist at the Heart Institute at Virginia Mason.

The Virginia Mason cardiologist “knew immediately” that the AFib Dominik was experiencing was serious and did an ultrasound that showed his heart had enlarged and his heart efficiency had substantially decreased. The cardiologist put Dominik on medications to lower and regulate his heart rate and he underwent two “cardioversions” in which he was sedated while attempts were made to shock his heart back into a normal rhythm. Likely due to the length of time he waited to come to Virginia Mason, both were unsuccessful.

Eventually, Dominik underwent cardiac ablation while in AFib. A catheter was inserted through the groin to the heart to eliminate the confused electrical signals within the heart’s atrium that cause atrial fibrillation. His heart converted into regular rhythm during the procedure and after two days, Dominik was walking around normally, and back at work the following Monday. Within four months, he was completely off all medications and his heart continues to stay in rhythm.

I feel as good as ever,” says Dominik, who got married four months after the procedure. He spent his honeymoon in Fiji. When he and his wife went out in a kayak in stormy conditions on a multi-mile trek, Dominik says he relished being outdoors, on the water and embracing life to the fullest extent. “When you’ve had heart problems, you really appreciate a return to normal life, whether you are engaging in ‘extreme activities’ or just walking up a flight of stairs.”


This story originally appeared on VirginiaMason.org. Meet other patients who shared their journey to better heart health, and learn more about the advanced services and dedicated care team at the Heart Institute at Virginia Mason.