He's Got His Rhythm Back

02-07-2017

A Healthy Heartbeat is Restored with Ablation

Poul Cederholm had been experiencing the warning signs for a couple years. He was always tired and sleeping a lot. It felt like all he did was work, eat and sleep, and he had been dealing with bouts of depression and anxiety. His overall quality of life had been in decline, but he couldn’t put a finger on the reason why. The Laguna Hills resident was having such difficulty keeping up with his work and family life that he was afraid he would lose his metal-stamping business and have to go on disability.

Cederholm wanted his normal lifestyle back. He wanted to regain his zest for living, and he wanted to be able to stop taking the anti-depressants that were lowering his energy level. The clouds of uncertainty that seemed to be following him began to lift when he went to see Jay Tiongson, MD, a cardiac electrophysiologist at Mission Hospital who specializes in cardiac device implantation and catheter ablation surgery.

When an EKG in preparation for thyroid surgery uncovered potential trouble spots in his heart in 2015, Cederholm knew he had to find a heart rhythm expert who would push his case forward. “As soon as I met with Dr. Tiongson, I could tell that I was going to be getting the best possible care,” Cederholm says. “His first question to me was, ‘How long has this been going on?’ He was completely focused on me and on figuring out what was wrong with my heart. He was like a detective who put together all the separate pieces that made up the big picture of my health.”

Cederholm’s diagnosis was made on the basis of his consultations with Dr. Tiongson and a full panel of tests. He was prescribed beta blockers, which are drugs that are used to manage a variety of heart conditions by slowing down the heartbeat and surpassing abnormal rhythms of the heart. He underwent a stress test to measure his heart’s performance. His heart was scanned with Mission Hospital’s advanced imaging technologies. And he wore a 24-hour Holter monitor, a small battery-operated EKG recorder the size of a cell phone. He wore the monitor during his daily activities while it recorded his heartbeat for analysis.

When all of the testing was completed, Dr. Tiongson gave Cederholm the news that he had been living with an abnormal heart rhythm caused by premature beats from the ventrical, also known as PVC, a type of arrhythmia. Arrhythmias result from interruptions in the normal pathways for heartbeat, and they disturb the way the heart transmits electrical impulses. There are several types of arrhythmia, which cause the heart to beat too fast too slow, or in an erratic manner. The most common symptoms are skipped beats or fluttering sensations in the chest, but other symptoms can include fatigue, shortness of breath, and spells of fainting or near-fainting.

“Serious, long-lasting arrhythmias put people at higher risk for passing out, fainting, stroke, and even sudden cardiac arrest, so those living with heart disease or symptoms of arrhythmia need regular EKGs and screenings to monitor their heart rhythm,” says Dr. Tiongson. “It’s important to get tested because not everyone who has arrhythmia notices an irregular heartbeat.”

Cederholm learned that his right ventricle, a chamber of the heart, was beating out of rhythm, which caused his heart to pump inefficiently. “My heart was operating at only 70 to 72 percent of its ability,” Cederholm says.

To restore normal rhythm, Cederholm followed Dr. Tiongson’s recommendation of ablation. Ablation is a procedure in which the surgeon inserts flexible wires, called catheters, into a millimeter-sized incision and guides them to the heart. “The catheters are tipped with electrodes that apply radiofrequency (RF) energy to a tiny area of the heart,” Dr. Tiongson says. “The RF energy removes the abnormal tissue that is conducting the electrical impulses which cause irregular rhythms, while leaving the rest of the heart undamaged.”

Ablation has a high rate of success and a low risk of complications, making it the preferred treatment for many types of arrhythmia. Mission Hospital augments the performance of complex ablations with a state-of-the-art magnetic navigation system called Stereotaxis. The system uses precision-guided magnets to remotely navigate the catheters through delicate cardiac pathways and treat the offending tissues with increased safety and success.

Cederholm was excited and eager to have the ablation, which Dr. Tiongson performed in November 2015. Cederholm was relaxed and awake for the procedure, whereby he was able to witness everything that happened. “I was so impressed with the surgical team,” he says. “It was like clockwork. Everyone knew exactly what to do, and the attending nurse was so caring and attentive, talking to me about my family and my life to make sure I didn’t doze off.” He recalls that the surgery lasted for about one hour. After, he was kept for observation for several hours, and he went home the same day.

Cederholm says he felt better almost immediately. “My first follow-up showed my heart was pumping at 100 percent,” he says, “and my life went back up to 100 percent too. No more anxiety, no more depression, no more naps.” At age 62, he reports that now he is exercising more, he can work again, and the color has come back to his face. He says he is doing so well that he doesn’t need to see Dr. Tiongson again until his next scheduled follow-up in June of 2017.

The takeaway, says Cederholm, is that people need to take charge of their health and find a doctor to partner with who is similarly motivated. He says, “You need to ask questions and pay attention to what the doctor says. Follow your instincts, and make sure you choose a doctor whose advice you trust and whose interest is focused on you and your health.”

Cederholm continues, "The care team at Mission Hospital is truly a team, in the sense that they are unified and proactive. Every doctor, nurse and care provider at Mission who helped me through my surgery is there for the same reason, and that’s to heal people. You can tell that every patient is important to them. They gave me my life back, so that I can give of myself and contribute to my work and my family.”

Learn more about the Mission Heart Institute.