Enjoying Life With a Heart That's Back in Rhythm
David Near of Midland, a serious cyclist, says he’s back at it, going as strong as before if not stronger, and is also doing other cardio and standard resistance workouts.
Ever since his heart’s electrical pathways were repaired last year, David Near of Midland no longer fears a sudden, dangerous slowdown of his heartbeat. Soon he will happily leave behind the emergency dose of heart medicine he’s carried on his keychain for years.
Near, who is retired from Dow and owns a consulting company, was diagnosed at age 29 with early-onset atrial fibrillation, or AFib. This serious condition, if not controlled, can increase the risk of stroke or heart attack.
“At first, I had tachycardia, the more common type of AFib that causes the heart to beat irregularly and extremely fast,” he said. Over the next 15 years, working with Cardiologist Robert Genovese, M.D., Near was able to successfully manage his condition with medications. Throughout these early years he experienced only one or two short episodes of AFib.
But then a dramatic change narrowed his medication options.
“Suddenly, I started having more frequent AFib episodes; but instead of my heartbeat racing, it would become dangerously slow,” he said. This type of AFib is called bradycardia. For an adult, a normal heartbeat is 60 to 100 beats each minute, and a well-trained athlete’s heart beats 40 to 60 times a minute. “The medications were no longer working, and when I was in AFib, my heart often beat as few as 20 times per minute.”
Dr. Genovese put Near on the only other medication then available for bradycardia. It helped for a number of years, but then he started having more AFib episodes and also needed stronger emergency medicine. Dr. Genevese told him that medication wouldn’t control his AFib forever. At some point he would have to consider cardiac ablation or another option. To start that discussion, Dr. Genovese referred him to Electrophysiologist Nilofar Islam, M.D., who specializes in heart rhythm disorders at MidMichigan Medical Center–Midland.
Dr. Islam explained how the heartbeat might be controlled with a pacemaker or restored with cardiac catheter ablation, a minimally invasive procedure performed at the Medical Center’s electrophysiology (EP) lab. Near decided not to have the procedure then, but to wait until the medications became ineffective, which could take several years.
In fact, it took less than two years. Near was on his way to Houston when a major AFib episode made his heartbeat drop dangerously low. Even though the emergency dosage he carried on his keychain successfully converted him back to regular rhythm in a couple of hours, Dr. Genovese told him to catch the next flight home. When his heart had not completely stabilized by the time he got to the doctor’s office the next morning, he was immediately sent to the Medical Center.
Near’s heart did stabilize the following day, but it was clearly time for the next stage of treatment. He and Dr. Islam agreed to do cardiac catheter ablation within 2 weeks. “I’m so fortunate that when the heart medicine was no longer working for me, Dr. Islam was waiting in the wings with a solution,” he said. “She was just fabulous, so reassuring and comforting to me, my wife, Karen, and my kids. She explained everything clearly and answered every question and concern.”
Dr. Islam explained that during the procedure she would map the electrical impulses within Near’s heart. She would then trigger the abnormal electrical impulses to locate areas that were misfiring, and eliminate (ablate) the misfiring areas with radiofrequency energy, so that only properly firing pathways remained.
During Near’s four-hour procedure, Dr. Islam found and successfully ablated seven problem areas. She told him later that one area in the upper right atrium was an oddity, seldom seen, and she felt that had caused the very slow heartbeat.
“For me as the patient, it was a fairly routine in-patient surgery. I only had to stay one night in the hospital after the procedure, which is standard,” he said. The small incision site on the upper thigh healed quickly, and his maintenance medications were gradually reduced over six months.
Near said it was great to have Dr. Islam and her capability right down the street and be able to avoid the stress and inconvenience of travel for the procedure. “I would not hesitate to recommend Dr. Islam to someone who needed to have cardiac catheter ablation,” he said. ”I also appreciated the excellent follow-up from Dr. Islam and the people in her office, particularly the full written summaries of every visit.”
Since his procedure Near has not had a single episode of AFib. He is now enjoying the ability to bike, hunt, golf and fish without worry. A serious cyclist, he says he’s back at it, going as strong as before if not stronger, and is also doing other cardio and standard resistance workouts.
“After dealing with atrial fibrillation for 25 years, I am now completely off heart medication for the first time since 1986, and have absolutely no restrictions whatsoever,” he said. “I’m glad I had the procedure. It changed my life, and the icing on the cake is I no longer have to carry the emergency meds on my key chain.”
MidMichigan Health offers a full array of heart and vascular services, including open heart surgery, vascular surgery, electrophysiology for heart rhythm problems and advanced interventional procedures. Those who would like more information on MidMichigan’s comprehensive program may visit www.midmichigan.org/heart.