Larry Martin, a salesman from Gibsonton, woke up one morning feeling dizzy and weak. He was 70 at the time, so he went to his doctor, who immediately called an ambulance to take him to the hospital because he had atrial fibrillation, an irregular heartbeat that would vacillate from as low as 44 beats per minute to as high as 200.
Of all the problems a heart can have, atrial fibrillation, or "a-fib," remains one of the most puzzling.
For reasons no one quite understands, some hearts develop spots of fibrous tissue that disrupt the cascade of electricity flowing from the top of the heart to the bottom during each beat. The result is an irregular heartbeat. The jostling of the blood in the heart caused by the irregular beats can create clots which, if they travel to the brain, can cause a stroke.
The treatment involves ablation — the destruction of those spots of fibrous heart tissue that disrupt the flow of electricity. A catheter inserted through an incision in the groin is run up to the heart, and destroys the fibrous spots with either liquid hydrogen or high heat.
Martin went to see Dr. Dilip Mathew, a cardiologist at Florida Hospital Pepin Heart Institute in Tampa, who put him on medication designed to normalize his heartbeat, and it worked fairly well, "but it was like a medical umbilical cord," said Martin. "I always carried my meds with me in a pill container I kept on my key chain. If my heart went out of rhythm I had to call the doctor, and he would immediately make changes in my medication."
Martin was accustomed to driving up to 1,000 miles a week for his job, but he started to feel uneasy about taking long trips, so Dr. Mathew suggested a new type of ablation that he helped to develop.
In a three-hour procedure — much shorter than the 6 to 8 hours once needed — he threaded a new type of catheter known as the Thermocool catheter through a small incision in Martin's groin, up an artery, and into the heart. There the catheter delivered heat produced by radiofrequency waves, and then immediately irrigated the ablated spots to dissipate the heat and prevent excessive damage to the tissue.
"One of the problems we had with traditional ablation was charring at the end of the catheter," Dr. Mathew said. "This would make the risk of stroke higher. The Thermocool significantly decreased that problem."
The ablation may cause temporary inflammation that can disrupt the heart rhythm, often making patients feel discouraged, but that usually goes away in two or three months, according to Dr. Mathew. "We have to educate patients about what to expect so they don't get disenchanted," he said. "We have to tell them some of these episodes are natural, and do not indicate procedure has failed."
Martin has returned to work, and has been doing interviews to promote the new technique that helped him. "People don't realize there's a highly successful procedure that can help them get their freedom back," he said.
Martin feels so good he has revived his goal of living to 100.
"The number of people in this country living to 100 doubles every few years," he said. "Why can't I be one of them?"
Tom Valeo writes frequently about health matters. He can be reached at firstname.lastname@example.org.