Six Ways to Heal a Heart
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Engage a young, healthy person in a discussion about the heart and you’ll likely be talking about true love, the nature of the soul or other such lofty philosophical topics. But broach the subject with someone over the age of 40 and it’s likely to veer in an entirely different direction, one that has more to do with medications than meditations on the meaning of life.
Heart disease affects people young and old, of course, but age itself is a major risk factor—the heart is a hardworking organ, after all, and eventually it does begin to wear out. Nearly three-quarters of Americans over the age of 60 have some form of heart disease, and the treatments are many, varied and ever more sophisticated. Today’s cardiologists, electrophysiologists and cardiovascular surgeons have access to a wide range of highly effective heart therapies—some incredibly complex, others surprisingly simple. We take a look at some of the fascinating new ways hearts are being healed in hospitals around the state.
A Cool New Treatment for Cardiac-Arrest Patients
Cardiac arrest (when the heart suddenly and unexpectedly stops beating) kills an estimated 325,000 people in this country every year. Those who survive often suffer severe brain damage.
Now, however, a remarkably low-tech treatment reduces the odds that brain damage will occur. St. Vincent’s Medical Center in Bridgeport, along with many top hospitals around the country, gives patients who’ve suffered cardiac arrest what might be described as a very “chilly” reception. They spend 24 hours or so literally packed in ice (or wrapped in a cooling blanket or put on an IV of chilled saline) to bring their body temperature down to between 90 and 93 degrees Fahrenheit. Called therapeutic hypothermia, this technique has been shown to help prevent brain and organ damage in one out of every six patients by temporarily and dramatically reducing the body’s need for oxygen.
Therapeutic hypothermia actually dates back to the days of Hippocrates, according to St. Vincent’s pulmonologist James Peppim, M.D., but it has only recently come back in favor. Cooling the bodies of cardiac-arrest patients helps prevent the cell death that would otherwise occur when the brain refills with blood after a period of deprivation. That triggers a “free-radical release that leads to programmed cell death,” Peppim says.
Though the treatment may sound extreme, Listy Thomas, M.D., a board-certified emergency physician at St. Vincent’s, says the therapy is actually quite effective. The most dramatic case she has seen, she says, occurred several years ago when a 17-year-old boy suffered cardiac arrest in his high school gym. “The coach used an AED to get his heart started again and when he was brought in, we started the hypothermia right away,” she recalls. “He was, amazingly, able to walk out of the hospital afterward with no brain damage whatsoever.”
Two-In-One: Hybrid Ablation for A-Fib
Atrial fibrillation (a-fib) describes a heart-rhythm disorder that affects the upper chambers of the heart in an estimated 2.5 million Americans. It is caused by abnormal electrical impulses that disrupt a person’s normal heartbeat. According to Murali Chiravuri, M.D., Ph.D, an electrophysiologist and cardiologist at Bridgeport Hospital, it can cause stroke, fatigue and other problems that make people feel quite sick.
A-fib is treated with a technique called ablation, essentially a form of cauterization that creates a scar-tissue barrier to block the abnormal signals. It can be done either with a catheter sent to the heart from a vein in the groin or with more invasive procedures, with advantages and disadvantages to each. But at Bridgeport Hospital doctors now use a new technique called “hybrid ablation” in which both are combined into one procedure. One doctor works on the heart from the inside as the other operates on the surface, providing a more effective, comprehensive ablation.
In addition to Chiravuri, the surgical team at Bridgeport Hospital’s Connecticut Cardiac Arrhythmia Center includes Robert Winslow, M.D., and cardiothoracic surgeon M. Clive Robinson, M.D. The team performed New England’s first hybrid ablation last June and the number of procedures performed successfully is now close to 20.