How I was Cured of Irregular Heart Rhythm

I've always considered myself an active sort and somewhat of a fitness buff. I played football and basketball in high school. I continued to play hoops years after. I also have done a couple of triathlons, run a marathon (Honolulu in 2001), did (and still do) weight training, and go kayaking. I also hike, an activity I still enjoy today.

A few years ago while hiking up a steep grade along one of the trails on my home island of Oahu in Hawaii, I began to labor. By labor, I mean I was gasping for breath, dizzy, and feeling like I was going to black out. Let me explain that I was in pretty good condition at that time, having hiked and weight trained and run regularly in a typical week. So when I labored that day on the trail, I chalked it up to being dehydrated or to eating something weird for breakfast, or to just having a bad day.

Classic male denial.

The problem was that I continued to have bad days. That is, whenever I exerted myself, I labored for breath. More rationalizing. More denial. I convinced myself the bad days would end at some point. Then I'd be my old self again, powering up trails like I always had.

Perhaps by divine intervention, a series of events, having nothing to do with bad days and labored breathing while hiking, led me to the emergency room of Wahiawa Hospital in central Oahu. One of the tests conducted on me during the visit was an EKG.

The emergency room doctor noted an irregularity in my heart beat. "I recommend that you make an appointment to see a cardiologist," he said. He referred me to one. My wife, my antidote for denial and rationalization, made sure I made the appointment and kept it.

Come to find out I was stricken with a condition called atrial flutter. What atrial flutter is, in layman's terms, is a malady that kept my heart from beating steadily and regularly. Instead, my ticker sputtered in between beats, sort of like how a car engine sputters when it has a dirty air filter or oil filter, or when it hasn't been tuned up in a while.

The doctor explained to me that the danger of atrial flutter is that my heart was not pumping blood well when it was sputtering/fluttering. And because my heart was malfunctioning, my heart and brain were not getting enough oxygen from my blood. This explained what was happening when I was exerting myself while hiking. This explained the gasping and dizziness and "fade-to-black" sensations I experienced.

I also found out that atrial flutter can come and go. In fact, I probably had the condition in the past, only to have my heart return itself to regular rhythm after a while.

My cardiologist, Dr. Michael Chan, put me on medication, namely a blood thinner called warafin (aka coumadin). The main purpose of coumadin was to prevent the formation of deadly clots in my blood. Because my heart was malfunctioning and was not thinning my blood as normal, the medication filled that gap.

Because I was in my mid-40s at the time, my doc thought that being on blood thinning meds for the rest of my life wasn't the best course. Instead, he suggested I undergo a procedure called cardioversion using a defibrillator. Recall a scene from one of those ER shows where the doc places an metal electrode on a patient's heart and yells, "Clear!" to all within earshot? And then the prone patient heaves upward from the jolt of electricity? Well, that is cardioversion. And that is what he wanted to do to reset my heart to normal.

Basically, cardioversion was meant to kickstart my heart back to regular rhythm. It was a safe procedure, said the doc. He had done it many times, with no casualties.

So I agreed, and arrangements were made to have the procedure done at a local hospital. I checked in, the anesthesiologist put me under, and the next thing I know I'm in the recovery room feeling groggy like I'd just gotten up from a nap.

"Is it done?" I asked the attending tech.

"All done," he said.

"Did it work?" I asked.

"Perfectly," was the reply

And post-procedure tests verified this.

The catch about cardioversion as a treatment for atrial flutter is that the flutter can return. As I recall, the doc told me the likelihood was 50%.
As it turned out, my heart was in the negative 50%. That is, for me the flutter returned, as confirmed in a follow-up visit to my cardiologist six months after the cardioversion.

With medication treatment again not being the best option for me, it was suggested that I try a more invasive (read: more risky) yet potentially more effective procedure called catheter ablation. Simply put, the doc would insert a long skinny tube (catheter) through the femoral artery by my groin and snake the tube through the artery to my heart. Electrodes at the tip of the tube would pinpoint areas of my heart that had been damaged and thus had created the irregular rhythm. Once located, heat could be applied through the tip of the catheter to ablate (destroy) the damaged sections of my heart thereby restoring regular rhythm.

Wanting an end to my heart woes, I agreed and enlisted the services of another heart doc for the ablation, which had, according to this doc, a 95% success rate of returning the heart to regular rhythm and keeping it there.

In short, the ablation worked. I was awake for the whole thing. I could hear my cardiologist, Dr. Edward Shen, humming merrily as he probed my heart with the catheter. I also could feel the heat being applied to my heart. Quite intense at times. I'd never had heartburn before, but I literally felt my heart burning during the operation. Afterward, the OR nurse even let me look at the catheter that had been snaked through me. Interesting sight though not pretty.

After a night's stay in the hospital I was home the next day.

After a week of low-key activity to let the catheter entry wound in my groin heal, I was cleared to return to regular functions. This meant I could hike, run, kayak, and do all the things I loved to do.

And I did. And 4 years later I haven't had an episode of bent-over gasping and near blackouts like I did when my heart was out of rhythm.

If I had known what I know now, I would have nixed the cardioversion and just done the ablation. Go with the sure thing. For those in a similar situation, I'd suggest talking to your cardiologist about all procedures. Do research. Ask pointed questions. Do not be afraid. There is a solution.