Afib and Heart Failure: Repairing a Faulty Heart

From an article by Tammy White with
Dr. Robert Messier
McLeod Cardiothoracic Surgical Associates

A round of golf followed by CPR, an automated external defibrillator, a heart catheterization and, then, a trip to the McLeod Heart & Vascular Institute – a busy day for John Pacholek.

As Pacholek’s golf buddies moved to leave the 18th green that January 2021 day, they saw him lying on the ground. After checking for a pulse, they began CPR. Then, a honeymooning Pennsylvania couple – a pediatrician and a medic – rolled up and just happened to be carrying an Automated External Defibrillator (AED) on their golf cart. They were able to get John breathing again. EMS transported John to Conway Medical Center for a cardiac cath and a referral to McLeod, where Cardiothoracic Surgeon Dr. Robert Messier stepped in.

“When John arrived at McLeod, his heart was both in chronic atrial fibrillation and heart failure,” said  Dr. Messier. “Atrial fibrillation is a type of heart arrhythmia that causes the top chambers of the heart to beat irregularly. Although medication can help some people with afib, Pacholek’s heart stayed in constant atrial fibrillation and would not convert back to a normal rhythm.

“Medication would not have corrected his problem,” said Dr. Messier. To treat his chronic atrial fibrillation, Dr. Messier used the  MAZE procedure and AtriClip.

The MAZE procedure cures atrial fibrillation by interrupting the  electrical patterns responsible for the irregular heartbeat. Dr. Messier used a radiofrequency probe to burn lesion areas in the heart tissue  without damaging the heart. Scar tissue generated by the lesions permanently helps redirect the electrical flow.

More than 90% of stroke-causing blood clots for atrial fibrillation patients are formed in the left atrial appendage, a pouch-like structure that protrudes from the upper chamber of the left side of the heart,” said Dr. Messier. “When a blood clot migrates out from this area, it can potentially cut off the blood supply to the brain, causing a stroke.”

To seal off Pacholek’s left atrial appendage, Dr. Messier surgically implanted the AtriClip, a small titanium metal clip that is placed around the appendage on the outside of the heart, sealing it off.

For more details on this story and procedures, click here and check page 34.