WAUSAU, Wis., July 8 Like an estimated 5 million other Americans, Barry Simonis had atrial fibrillation, a common heart condition that greatly increases the risk of stroke and causes the most important muscle in our bodies to beat irregularly.
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Aspirus cardiovascular surgeon John Johnkoski, M.D., recently performed an advanced surgical procedure called thoracoscopic ablation on Simonis to correct the condition that plagued the Rosholt resident for more than 10 years. During the procedure his heart went back into rhythm, and he went home in less than two days.
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"This is a huge advance because this procedure can be used on patients that until just recently, would have required open-heart surgery," said Dr. Johnkoski, one of fewer than 50 physicians in the country that perform thoracoscopic ablation. "This (procedure) allows people to get off medications, prevents strokes, and helps people live longer."
Impact of atrial fibrillation
The irregular heartbeat associated with atrial fibrillation is caused by a faulty electrical impulse, which can be fairly well-managed with medications and a treatment called cardioversion, a brief procedure where a doctor delivers an electrical shock to convert an abnormal heart rhythm back to normal rhythm. Even if the condition is closely monitored and managed, however, it still raises the risk of stroke and can cause heart damage over time.
"For me, atrial fibrillation was more bothersome than anything," said the 57-year-old Simonis. "I just got tired of all the trips to the doctor for blood work, and I had 14 cardioversions in about 10 years. It's all such an inconvenience."
People with atrial fibrillation usually have to take Coumadin, a blood thinner that reduces the risk of stroke. While Coumadin is effective in preventing strokes, the drug can produce side effects that are difficult for some people to handle.
"Most people undergo procedures for atrial fibrillation because they can't handle the meds," Dr. Johnkoski said. "Coumadin doesn't mix well with an active lifestyle. Patients will have to remain on their medications for a few months after a procedure, but after that, their quality of life will improve dramatically."
Benefits of thoracoscopic ablation
Surgery for atrial fibrillation previously required an open-heart procedure and an extensive recovery period. In recent years, minimally-invasive options like thoracoscopic ablation have been developed, which allow doctors to perform surgery on a beating heart without opening the chest.
Thoracoscopic ablation can treat persistent, or chronic atrial fibrillation, as well as paroxysmal, or occasional atrial fibrillation. Patients only need one procedure to correct the problem and be taken off medication. Catheter-based treatments can require multiple procedures.
During a thoracoscopic ablation procedure, a surgeon makes three or four small incisions on a patient's side, and uses the latest imaging technology to guide special instruments through the ribs and to the heart.
With the instruments in place, the surgeon creates precise scars on the heart to block the faulty electrical impulses that cause the heart to beat irregularly. The left atrial appendage of the heart is removed because stroke-causing blood clots often form here.
Thoracoscopic ablation isn't appropriate for everyone, and anyone with atrial fibrillation thinking about undergoing a corrective procedure should discuss all options with their physician.
"I'm glad I was a candidate for this procedure rather than something more major," Simonis said. "I'm glad I had it done. The biggest thing for me was getting off the Coumadin. Even though there are plenty of other dangers, I have never cared for taking any kind of pill."
A photo of Dr. Johnkoski is available.
SOURCE Aspirus
