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Dr. Gemma: Catheter ablation is a long-awaited alternative to medications.



Published: Fri, February 22, 2013 @ 12:00 a.m.

Hospital makes the beat go on

By William K. Alcorn

alcorn@vindy.com

YOUNGSTOWN

Paul Lisko noticed his heart seemed to occasionally skip a beat.

But the Struthers man did not pay a lot of attention to it until an electrocardiogram during a physical revealed he had atrial fibrillation, a heart arrhythmia that is potentially fatal.

Atrial fibrillation is the most common heart arrhythmia. Arrhythmia is when the heartbeat is too fast, too slow or irregular.

Lisko used medications to regulate his heartbeat for several years until Dr. Lee Gemma, a board-certified cardiologist who specializes in treating heart-rhythm disorders, arrived at St. Elizabeth Health Center last year.

At about the same time, St. Elizabeth renovated its cardiovascular lab and purchased advanced technology for the treatment of erratic heartbeats at a combined cost of some $1.1 million.

The confluence of events — Lisko’s heart problem, Dr. Gemma’s training and skills and the new lab equipment — resulted in Lisko becoming the first patient at St. Elizabeth to undergo a trial fibrillation surgery in September.

Lisko and Dr. Gemma were the speakers at Humility of Mary Health Partners’ The Beat Goes On, an event Thursday at Our Lady of Mount Carmel Church Hall. It was designed to raise awareness about heart disease and describe how catheter ablation for atrial fibrillation works.

Interviewed before the event, they discussed the procedure that, while it is not new technology, is new to the Mahoning Valley.

Lisko, 62, an ordained deacon of the Roman Catholic Church and a chaplain at St. Elizabeth Health Center Boardman, said he didn’t have to leave the area to have his heart problem fixed.

“I was surrounded by a group of people I have known for years. I felt comfortable here at St. Elizabeth. It is a very healing environment,” he said.

St. Elizabeth offers the catheter ablation as a treatment option for patients with atrial fibrillation, hospital officials said.

Atrial fibrillation occurs if rapid, disorganized electrical signals cause the heart’s two upper chambers, called the atria, to fibrillate or contract very fast and irregularly.

Lisko, who exercised two or three hours a day, six or seven days a week before surgery, noticed symptoms such as anxiety and fatigue, but attributed them to something else.

Though Lisko continued to exercise and did not miss work, some patients are afraid to leave the house for fear they will have an episode while driving, said Dr. Gemma of Poland.

Also, Dr. Gemma said over time a high heart rate can result in serious health problems. The primary concerns are reducing the risk of a stroke and preventing congestive heart failure, he said.

Catheter ablation is a long-awaited alternative to medications intended to normalize the heartbeat for the long term, Dr. Gemma said.

But the most effective medications also have the potential for toxic side effects, he added.

In atrial fibrillation, blood pools in the atria and isn’t pumped completely into the heart’s two lower chambers, called ventricles. As a result, the upper and lower chambers don’t work together, and that can increase the risk of stroke.

Catheter ablation is an invasive cardiac procedure, done under general anesthesia, in which five catheters (thin, flexible wires with electrodes) are put into a blood vessel in the patient’s arm, groin (upper thigh), or neck and guided into the heart. The surgeons use a three-dimension map of a patient’s heart, created by information from a computerized tomography — CT scan — and/or magnetic resonance imaging, to guide them in performing the catheter ablation.

Anti-arrhythmic drug therapy has provided symptomatic relief in many patients with atrial fibrillation, but radio-frequency catheter ablation of atrial fibrillation has emerged as a preferred alternative - treatment method, Dr. Gemma said.

The procedure can take three, four or up to 10 hours, depending on the type and severity of the atrial defibrillation, he said.

Lisko, whom Dr. Gemma said had a “lone atrial fibrillation,” meaning he has no other heart problems, went home the day after his surgery where he stayed a week before returning to work.

“It was two or three weeks before I started exercising again,” Lisko said.


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