Perspectives From Both Sides of the EP Table

One week after my ablation, I pushed a Toyota sports car more than two blocks when its battery went kaput.

Sure, I was a little pooped, but that is to be expected when a 60-year-old man decides to push a car rather than call a tow truck.

Acting like a teenager whose hot rod had run out of gas probably served as a good test. My heart rate didn’t soar. Nothing fluttered. If I had any doubts, I felt assured: my SVT was a thing of the past.

I am a registered cardiovascular invasive specialist (RCIS) and registered cardiac electrophysiology specialist (RCES) at The Heart Hospital at Deaconess Gateway. On May 2, 2012, I experienced the rare privilege of seeing the lab from the perspective of both patient and clinician.

I’ve worked in EP and catheterization labs for decades. I’ve assisted with ablations on hundreds of patients. Even so, I admit I was anxious for days before the procedure.

As it turned out, I worried for no reason. The worst pain of the day came early when a nurse inserted my IV.

I chose conscious sedation, and for the most part, was awake during the two-hour procedure. I could feel the ablater do its work. Since the ablation, I’ve been asked to describe the sensation. I can’t. It’s odd — like the pressure of pinching, but without the pain.

Dr. Ashwani Bedi, who I work with daily, did the procedure. On the third try, he induced my bad rhythm (AVNRT). After the ablation, Dr. Bedi used Isuprel to 5 mcg twice to get my heart to go into the fast pace. It wouldn’t.

As Dr. Bedi put it, he was “cautiously optimistic” my SVT was gone. In the world of cath and EP labs, I knew it was unlikely for him to make a statement of absolute certainty. I didn’t need it, though. I felt confident in my cure.

I’ve always been blessed with good health. A partial thyroidectomy in 1989 and arthroscopy on my right knee in 1985 are the only times I’ve been a patient in an OR.

Then, about 12 years ago, I noticed a fast heart rate for no reason. At that time, the arrhythmia happened a couple times a year at most.

One day, the arrhythmia started while I was in the outpatient CVL. I hooked myself up to a monitor and printed out a strip. I showed it to one of our cardiologists, who told me I had experienced SVT.

I felt somewhat relieved because SVT comes from the atrium, not the ventricles. I researched the possible causes and learned the arrhythmia is a side effect of Synthroid, which I took after my thyroidectomy. I asked my family physician to take me off this medication. He weaned me off, monitoring my lab work.

Then, one evening while I was sitting in my living room watching TV with my wife, I noticed a rhythm change. This time, it was not like previous arrhythmia episodes. I recognized it right away because I know what it looks like on the monitor. I took my pulse and found I was in atrial fibrillation.

I tried to subdue it, but couldn’t. A trip to the emergency room confirmed I was in AF. I started taking a Lopressor 50 mg QD, ASA 81 mg QD and flecinade 50 mg BID. Later, the Lopressor was increased to 100 mg QD.

About six months before my ablation, my SVT episodes had increased dramatically to one to two times a week. I don’t know how much life’s circumstances had to do with my heart acting fluky, but, to say the least, my life was in a state of flux.

My wife of nearly 40 years had died from complications of COPD a few months prior. My daughter and two granddaughters, ages 5 and 7, had moved into my home. I had entered a relationship with another woman, and I had started a rigorous exercise program, resulting in a 62-pound weight loss.

However, my SVT episodes didn’t happen after exertion. For example, one day I rode my bike 26 miles and dug the bed of a very long sidewalk without a hint of problems, but when I bent down to pick up something or tie my shoes, the SVT would flare up.

I knew it was time for an ablation. Although I was pleased to know the SVT episodes would end, I hated the thought of going through the procedure. I wanted to be like Dorothy in The Wizard of Oz — click my heels three times and be done with it.

I wasn’t that lucky. I spent a little more than 24 hours in the hospital after my procedure. 

As a result of going through the ablation, I’ve learned a lot of things about our team’s interaction with patients. Of course, I was more likely comfortable than they might be, because I knew everyone in the lab. I chose my doctor, nurse, and anesthesiologist. Our patients aren’t that fortunate.

In general, patients have a fear of the unknown. By contrast, I’ve been in the EP lab for years. I knew every step of the procedure. I even directed the staff to the correct cabinet for the ablation catheter that Dr. Bedi wanted from the table.

Experiencing life on both sides of the EP table has given me more sympathy for our patients. At least now there is one person on the working side of the table who has been the patient. I feel much better prepared to console them as a result.

To ease our patients’ anxiety, I plan to share my experience with as many as I can. And while I’m at it, I’ll tease them and tell them that an ablation may give them superhuman powers. If they are as lucky as I am, they, too, may be able to push their car for blocks in a week or two.