Listen to your heart, especially if it flutters, speeds, or skips a beat
As a busy tour guide for a travel agency, Alice Stickney became concerned when she began to experience a racing heartbeat during trips, even when walking on a nearby track for exercise. “Every once in a while, my heart felt like it was running away from me,” said the East Lyme resident who is in her early 70s.
She turned to physicians and services of the Heart and Vascular Center (HVC) at Lawrence + Memorial Hospital. In 2018, she saw cardiologist Roshank Bagheri, MD, of Northeast Medical Group, who diagnosed Stickney with paroxysmal atrial fibrillation (AFib), a periodically fast and irregular heartbeat, at times more than 100 beats per minute. Stickney was soon taking medication to treat her AFib as well as a blood thinner because AFib put her at a higher risk for stroke.
But the AFib medication was making Stickney feel tired. Dr. Bagheri told her about another treatment option, cardiac ablation, and referred her to electrophysiologist Ralph DeBiasi, MD, of Yale Medicine, who leads the electrophysiology program at L+M’s Heart and Vascular Center.
Electrophysiology (EP) is a specialty of cardiology that deals with irregular heart rhythms (arrhythmias), with AFib being the most common. Age of onset is typically in the 60s and 70s, said Dr. DeBiasi, but the disease can often affect much younger patients. Other arrhythmias include atrial flutter, bradycardia, supraventricular tachycardia, sick sinus syndrome, premature ventricular complexes, Wolff-Parkinson White syndrome, ventricular tachycardia or ventricular fibrillation.
“Over the past decade Yale New Haven Health has partnered with L+M Hospital to enhance the local delivery of advanced cardiovascular specialties and services,” said Brian Cambi, MD, HVC medical director, adding that multiple services have been developed with support of Yale Medicine and Northeast Medical Group cardiologists. In addition to electrophysiology, HVC services include interventional cardiology for emergency and elective angioplasty, advanced heart failure, and vascular medicine.
The convenience of HVC services offered locally is a draw for patients, said Dr. DeBiasi, who shares
an office in Waterford with fellow Yale Medicine electrophysiologist Jude Clancy, MD. “We offer more full-time comprehensive care, both in the hospital and in the office, so if their cardiologist refers them to electrophysiology they don’t have to travel to New Haven for consultation or treatment.”
As part of her care, Stickney’s tests included an ultrasound of the heart (an echocardiogram) conducted at L+M Hospital. The full range of EP-related tests available at L+M include Holter and event monitoring for evaluating and diagnosing heart rhythm abnormalities, transesophageal echocardiogram to capture clear images of the heart’s structure, and tilt table testing to help identify the cause of fainting.
L+M offers comprehensive treatment options for arrhythmias. Pacemaker or defibrillator devices that may help improve the heart’s rhythm are implanted at the hospital’s two modern cardiac catheterization labs. Cardiac resynchronization therapy, which combines a pacemaker or defibrillator with a special type of pacing, is an EP treatment for patients with congestive heart failure. “The idea is, if you pace the heart in a way that resynchronizes the electrical system, then you can actually improve the patient’s heart function and energy level and they can feel better on a day-to-day basis. That’s one of the most powerful kind of therapies we can give people,” said Dr. DeBiasi.
Although many arrhythmias can be treated with medication, cardiac ablation is recommended for some patients, like Stickney. Typically a three- to four-hour procedure, this minimally invasive procedure uses a technique known as mapping to get 3D pictures of the heart chambers to determine where to use a specialized catheter to ablate or modify areas of the heart tissue to eliminate triggers for AFib.
Success rate of an initial ablation for AFib is 65 to 70 percent, said Dr. DeBiasi, also on staff at Yale New Haven Hospital (YNHH) where ablations are performed.
Stickney opted for the ablation, having pre-procedure tests of a CT scan and blood draw at L+M Hospital. In October 2019, she traveled to YNHH for the procedure performed by Dr. DeBiasi. She was discharged the next day, back to “feeling totally normal” about a week later, and will continue to see Dr. DeBiasi for follow-up care.
“I feel good. I don’t feel my heart at all, so that’s a good thing,” said Stickney who no longer takes anti-arrhythmic medication but remains on the blood thinner. Now that she’s able to exercise again, Stickney said, “I feel much better.”
*This article was written prior to the coronavirus pandemic.