A Healthy Heartbeat is Restored with Ablation
Poul Cederholm had been experiencing the warning signs for a couple years.
He was always tired and sleeping a lot. It felt like all he did was work,
eat and sleep, and he had been dealing with bouts of depression and anxiety.
His overall quality of life had been in decline, but he couldn’t
put a finger on the reason why. The Laguna Hills resident was having such
difficulty keeping up with his work and family life that he was afraid
he would lose his metal-stamping business and have to go on disability.
Cederholm wanted his normal lifestyle back. He wanted to regain his zest
for living, and he wanted to be able to stop taking the anti-depressants
that were lowering his energy level. The clouds of uncertainty that seemed
to be following him began to lift when he went to see
Jay Tiongson, MD, a cardiac electrophysiologist at
Mission Hospital who specializes in cardiac device implantation and catheter ablation surgery.
When an EKG in preparation for thyroid surgery uncovered potential trouble
spots in his heart in 2015, Cederholm knew he had to find a heart rhythm
expert who would push his case forward. “As soon as I met with Dr.
Tiongson, I could tell that I was going to be getting the best possible
care,” Cederholm says. “His first question to me was, ‘How
long has this been going on?’ He was completely focused on me and
on figuring out what was wrong with my heart. He was like a detective
who put together all the separate pieces that made up the big picture
of my health.”
Cederholm’s diagnosis was made on the basis of his consultations
with Dr. Tiongson and a full panel of tests. He was prescribed beta blockers,
which are drugs that are used to manage a variety of heart conditions
by slowing down the heartbeat and surpassing abnormal rhythms of the heart.
He underwent a stress test to measure his heart’s performance. His
heart was scanned with Mission Hospital’s advanced imaging technologies.
And he wore a 24-hour Holter monitor, a small battery-operated EKG recorder
the size of a cell phone. He wore the monitor during his daily activities
while it recorded his heartbeat for analysis.
When all of the testing was completed, Dr. Tiongson gave Cederholm the
news that he had been living with an abnormal heart rhythm caused by premature
beats from the ventrical, also known as PVC, a type of arrhythmia. Arrhythmias
result from interruptions in the normal pathways for heartbeat, and they
disturb the way the heart transmits electrical impulses. There are several
types of arrhythmia, which cause the heart to beat too fast too slow,
or in an erratic manner. The most common symptoms are skipped beats or
fluttering sensations in the chest, but other symptoms can include fatigue,
shortness of breath, and spells of fainting or near-fainting.
“Serious, long-lasting arrhythmias put people at higher risk for
passing out, fainting, stroke, and even sudden cardiac arrest, so those
living with heart disease or symptoms of arrhythmia need regular EKGs
and screenings to monitor their heart rhythm,” says Dr. Tiongson.
“It’s important to get tested because not everyone who has
arrhythmia notices an irregular heartbeat.”
Cederholm learned that his right ventricle, a chamber of the heart, was
beating out of rhythm, which caused his heart to pump inefficiently. “My
heart was operating at only 70 to 72 percent of its ability,” Cederholm says.
To restore normal rhythm, Cederholm followed Dr. Tiongson’s recommendation
of ablation. Ablation is a procedure in which the surgeon inserts flexible
wires, called catheters, into a millimeter-sized incision and guides them
to the heart. “The catheters are tipped with electrodes that apply
radiofrequency (RF) energy to a tiny area of the heart,” Dr. Tiongson
says. “The RF energy removes the abnormal tissue that is conducting
the electrical impulses which cause irregular rhythms, while leaving the
rest of the heart undamaged.”
Ablation has a high rate of success and a low risk of complications, making
it the preferred treatment for many types of arrhythmia. Mission Hospital
augments the performance of complex ablations with a state-of-the-art
magnetic navigation system called Stereotaxis. The system uses precision-guided
magnets to remotely navigate the catheters through delicate cardiac pathways
and treat the offending tissues with increased safety and success.
Cederholm was excited and eager to have the ablation, which Dr. Tiongson
performed in November 2015. Cederholm was relaxed and awake for the procedure,
whereby he was able to witness everything that happened. “I was
so impressed with the surgical team,” he says. “It was like
clockwork. Everyone knew exactly what to do, and the attending nurse was
so caring and attentive, talking to me about my family and my life to
make sure I didn’t doze off.” He recalls that the surgery
lasted for about one hour. After, he was kept for observation for several
hours, and he went home the same day.
Cederholm says he felt better almost immediately. “My first follow-up
showed my heart was pumping at 100 percent,” he says, “and
my life went back up to 100 percent too. No more anxiety, no more depression,
no more naps.” At age 62, he reports that now he is exercising more,
he can work again, and the color has come back to his face. He says he
is doing so well that he doesn’t need to see Dr. Tiongson again
until his next scheduled follow-up in June of 2017.
The takeaway, says Cederholm, is that people need to take charge of their
health and find a doctor to partner with who is similarly motivated. He
says, “You need to ask questions and pay attention to what the doctor
says. Follow your instincts, and make sure you choose a doctor whose advice
you trust and whose interest is focused on you and your health.”
Cederholm continues, "The care team at Mission Hospital is truly a
team, in the sense that they are unified and proactive. Every doctor,
nurse and care provider at Mission who helped me through my surgery is
there for the same reason, and that’s to heal people. You can tell
that every patient is important to them. They gave me my life back, so
that I can give of myself and contribute to my work and my family.”