Treating Atrial Fibrillation – Nathan Lott’s Cryoballoon Patient Story
How Heart Ablation Changed a Patient's Life
Convincing doctors she had atrial fibrillation was difficult. Once she did, treating it with an ablation procedure was the answer.
By Beth W. Orenstein
Medically Reviewed by Farrokh Sohrabi, MD
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In March 2009, Debbe McCall woke up one morning around 5 a.m. as usual and knew something wasn’t right. Her heart was racing, her pulse was fast (121 beats per minute), and her blood pressure was abnormally high (159/121).
She skipped her three-mile walk but went to work out with her trainer. Less than 45 minutes into her routine, she was short of breath and exhausted.
McCall didn’t feel good enough to drive to the nearest open ER, which was more than an hour away, so she called her primary care doctor, who prescribed a beta blocker to slow her heart and told her to see a cardiologist.
The next morning she was fine, but when McCall followed up with the cardiologist, he examined her and told her that her symptoms were the result of anxiety and menopause.
McCall knew he was wrong, but what could she do? For the next year she kept close tabs on her blood pressure and pulse. At least once a week, she would find that they jumped all over the place.
McCall, whose mother had her first heart attack at age 49, kept track not only of her vital signs but also of her sleeping patterns, her stress levels, her food and water intake, and even the weather. She was looking for a connection.
Standing Order for EKG
McCall’s primary care doctor had told her that the next time she felt her heart racing, she should come have an EKG, a test that records your heart’s electrical activity. “I had a standing order at her office,” she said.
Eventually McCall had an EKG that her doctor’s office faxed to the cardiologist she had seen the year before. This time the cardiologist saw the problem: McCall had atrial fibrillation, a condition in which her heartbeat would become abnormal.
When the medications he prescribed didn’t relieve her symptoms and caused her to bruise excessively, McCall decided to consult an electrophysiologist (EP), a cardiologist who specializes in the heart’s electrical activities.
She talked to six EPs until she found a good fit. The doctor agreed she was a good candidate for a radiofrequency ablation for atrial fibrillation.
Radiofrequency ablation is a heart procedure that uses low-voltage, high-frequency electricity to disrupt the electrical current that causes the heart to beat irregularly. McCall underwent the procedure in May 2010, 14 months after her first episode of afib and two months after seeing the cardiologist for a second time.
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Afib Treatment Guidelines Updated
In March, the American Heart Association, the American College of Cardiology and the Heart Rhythm Society released updated guidelines on treating patients with afib. Among the new recommendations was to use ablation more frequently.
Hugh Calkins, MD, president of the Heart Rhythm Society, said the new guidelines promoting the use of ablation are in keeping with the results of multiple studies and clinical experience. These show the minimally invasive procedure is more effective than drug therapy.
“The last time the afib guidelines in the United States had been rewritten was 2006,” said Dr. Calkins, director of the Atrial Fibrillation Center and a professor of medicine at Johns Hopkins Hospital in Baltimore. “Catheter ablation has advanced a lot since then.”
If the patient has intermittent atrial fibrillation, is otherwise healthy and doesn’t have heart failure, the procedure is likely to be successful at one-year follow-up in 60 to 80 percent of cases, Calkins said.
Catheter ablation for atrial fibrillation is not a cure for all patients. Over the first five years after a successful procedure, afib returns in about one out of four patients. For these patients, it may be necessary to repeat the heart procedure, Calkins said.
Ablation Procedure Declared a Success
For about three months after her ablation for afib, McCall, now 56, continued to experience an irregular heartbeat and worsening symptoms.
McCall had gotten an infection from the ablation procedure that led to several other infections for several months. With the help of integrative medicine practitioners, the infections cleared up and her irregular heartbeats stopped. “I have had no signs of afib since August 2010, and I am on no medications for it,” she said. Her EP electrophysiologist has since declared her ablation a success.
As a volunteer with StopAFib.org, an online resource dedicated to helping people with atrial fibrillation, McCall would recommend ablation to anyone who is comfortable with surgery and doesn’t want to be on medications. Most important, she said, find a doctor who you can work with to find the treatment plan that’s right for you.
Video: Heath Flicker - Cardiac AF Cryoablation Patient
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