Innovative cardiovascular procedure performed at Harrison Medical Center
February 28, 2013 · 2:26 PM
BREMERTON — Cardiac arrhythmias can be fatal when untreated. Ventricular tachycardia is one of those types of irregular rhythms.
Randall (Randy) Peterson knows this, first hand. The daily effort of regulating his heartbeat was becoming an overwhelming and life-threatening task.
“My ICD [internal cardiac defibrillator] had gotten to the point where it was firing daily, even multiple times a day,” Peterson recalled. “I just couldn’t enjoy life the way I’d envisioned it.”
After a successful career in the Coast Guard, he and his wife, Mercedes, looked forward to trips on their sailboat throughout the Pacific Northwest.
However, his worsening heart condition had put a stop to their plans.
“I’d even put a sign on the boat ‘for sale,’” said Peterson. “I thought our sailing days were over.”
To help Peterson and dozens like him each year, the cardiovascular team at Harrison Medical Center, led by electrophysiologist Nathan Segerson, MD, of Kitsap Cardiology Consultants, performed a successful mapping and ablation of an unstable ventricular tachycardia patient using the Impella left ventricular assist catheter.
On Feb. 6, Harrison was the first hospital in the Northwest to employ this type of dramatic, life-saving procedure using the Impella device.
Collaborating with Dr. Segerson on this procedure were members of Harrison’s cardiothoracic surgery team, including cardiac anesthesiologist Chai Kanithanon, MD; cardiothoracic surgeons Chris King, MD and William Reed, MD; and cardiologist Satyavardhan Pulukurthy, MD.
Peterson was Harrison’s first patient to undergo this procedure, which enables patients to receive this state-of-the-art care close to home.
“The rhythm abnormality this patient was suffering from was immediately life-threatening every time it occurred. Without the defibrillator shocking him back to life, he was near death multiple times per day,” said Dr. Segerson. “To be requiring ICD shocks so frequently is simply not a life worth living, and medication options had failed. Without an ablation procedure to prevent the electrical sparks from happening, the only recourse was to give up and let this heart rhythm problem take his life.”
In order to create a map of and ablate the origin(s) of the dangerous arrhythmia, the electrophysiologist needs to sustain the heart’s rhythm for prolonged periods of time. This device, called Impella, is a highly advanced heart catheter that pumps blood out of the heart and to the body. It is inserted into the left ventricle (the heart chamber that pumps oxygenated blood to the body) to ensure proper blood flow while the physician creates a map of the electrical activity. The Impella device ensures sustained cardiac output during that time.
This procedure would not have been possible without this supportive technology. “When medications fail, and when standard ablation approaches are not feasible (because of very severe and instant loss of blood pressure), prior to the availability of this technology we might have considered heart transplant. However, that approach is simply not practical for older patients or for patients with multiple health problems,” said Dr. Segerson.
In the case of rapid ventricular tachycardia, the heart doesn’t pump a sufficient amount of blood out of the heart to maintain blood pressure and perfusion. The anesthesiologist, in this case Dr. Kanithanon, uses cerebral monitoring and other complex hemodynamic supportive measures to ensure adequate blood flow to the patient’s vital organs (including the brain) during this procedure.
The combination of Harrison’s premier team of cardiovascular experts and these leading-edge technologies allowed Randy to have this progressive treatment done for what’s been a worsening, debilitating, and dangerous condition for many years.
And, what’s the first thing Randy and his wife plan to do when he gets home? You guessed it: “I’m pulling that ‘for sale’ sign off my boat,” he said.