November 27, 2009

CHIEF'S SURGERY - NOVEMBER 23,2009







Greenville, South Carolina doctors use state-of-the-art
surgery to restore normal heartbeats.


COUSIN, ROOSEVELT GILLIAM III IS RECOGNIZED AS A MAJOR
AUTHORITY IN THE FIELD OF ELECTROPHYSIOLOGY. "THIRD," WHILE NOT DIRECTLY INVOLVED, HELPED CLARIFY THE CONCEPT BEHIND THE PROCEDURE AND MADE IT EASIER FOR MYSELF AND VALERIE TO EMBRACE THE OPERATION WITHOUT ANXIETY.
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THIS ARTICLE WAS IN THE GREENVILLE NEWSPAPER THE DAY AFTER I HAD THE SAME BASIC SURGERY AT A NEIGHBORING HOSPITAL.
These days, Dee Bauknight feels like she’s been subject to a miracle.
After suffering with an erratic heartbeat – technically, atrial fibrillation – for 25 years, Bauknight was afraid of the rigors of daily living. But on Oct. 22, she had a cutting-edge surgery called cardiac ablation that brought her back to normal.
“I have had a miracle,” Bauknight said. “I am raking leaves, and before I would have been afraid to do that. I can drive. I can do anything.”
While little known, about 5 million Americans have atrial fibrillation or AFib, and 300,000 cases are diagnosed each year, according to a study published in the Journal of the American Medical Association.
Here in South Carolina, we are one of the national leaders in strokes, so having another weapon in the arsenal to fight the problem is welcome.
According to Dr. Craig McCotter, director of the Atrial Fibrillation & Arrhythmia Center, Cardiac Electrophysiology, Upstate Cardiology in Greenville, the center is one of only a handful in the United States. McCotter started his team in Columbia – the first in South Carolina – and operated there for three years before everyone moved to Bon Secours St. Francis Hospital.
“There is a huge need for this,” McCotter said about the cardiology niche, “but few people go into electrophysiology because it has the longest residency. It takes eight years of training after medical school.”
But that extra experience pays off. McCotter and his five-man team mix science and art in dealing with human hearts.
“You have to feel your way through the heart,” McCotter said, explaining the procedure where a catheter is inserted into the groin area and snaked up and into the heart. “There is no text book case, because each patient is so different.”
What McCotter and his team treat is atrial fibrillation, a condition in which the upper chambers of the heart beat irregularly or too fast. AFib occurs when the heart’s two small upper chambers quiver instead of beating.
Symptoms include a racing or irregular heartbeat, an overall feeling of weakness or lethargy, and dizziness, sweating or chest pain. AFib can worsen when patients drink alcohol, smoke, are obese, have sleep apnea, hypertension, congestive heart failure and more.
While the racing heart is scary in itself, when blood isn’t completely pumped from the heart chambers, it can pool and clot and eventually cause a stroke. In fact, about 15 percent of strokes occur in people with AFib.
Bauknight’s experience with AFib began about 25 years ago when she was running through an airport.
“I thought, ‘My heart is beating in a really strange way,’” Bauknight recalled. “And then it kept occurring.”
In 2001, she had a stroke. She also began passing out or blacking out. She was put on “a lot of drugs,” she said, but that was of little help. All day long, her heart beat erratically, stopped, and then restarted.
Bauknight lived in fear, but as she began to learn more about her condition, she discovered Dr. McCotter’s work.
The AFib Center now attracts patients from around the world, McCotter said. And he hasn’t encountered complications in more than 1,000 procedures.
Which isn’t to say that the procedure is for everyone, he said. He has to evaluate every patient to ensure each one is a good candidate for the procedure.
“If they’re not,” he said, “we do have every option available including pacemakers and medication.”
In the “delicate and dangerous” procedure, McCotter and his team use sophisticated 3-D scans, cardiac echo and cell mapping to find cells in the left, upper chamber of the heart that cause the erratic heartbeat. McCotter then uses ablation – in effect, he burns them with radio waves to destroy the individual cells – to help the heart return to normal.
“The biggest problem is getting complete ablations, but not to destroy so many cells as to cause complications,” he said. “If you don’t ablate enough cells, they can regrow.”
An average procedure takes about three hours, and patients are usually discharged the next day, and able to return to work in three days, McCotter said.
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By Mike Foley • Staff writer • November 24, 2009

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