A stitch—and beat—in time

Like more than 2 million Americans,  81-year-old Adelyne Panos had atrial fibrillation (AF).Like more than 2 million Americans,  81-year-old Adelyne Panos had atrial fibrillation (AF). “This is a condition in which the top chambers of Adelyne’s heart—the atria—were activating at more than 700 beats per minutes (bpm) rather than the normal 60 to 100 bpm,” explains Gundersen cardiologist Julio Bird, MD. “There was no organized rhythm so her heart could not pump blood like it should. This could eventually lead to heart failure or stroke. In fact she was already displaying symptoms of heart failure.”

AF may be episodic or present all the time. Symptoms range from mild to severe and can include:

  • Heart palpitations (fluttering, irregular, hard or faster-than-normal beats in the chest)
  • Chest pressure or pain
  • Lightheadedness
  • Fainting
  • Shortness of breath
  • Fatigue

"A couple of years ago, I started to have trouble breathing and walking any distance. I felt like I might pass out and was short of breath. I thought it was due to my age,” recalls Adelyne.

Cardiology nurse practitioner Debra Fahey put Adelyne on a 24-hour heart monitor which recorded a couple of AF episodes. During these episodes, the regular pumping action of the atria (upper chambers) becomes disorganized and instead of a steady heart rhythm, the heart beats irregularly. This is caused by chaotic electrical impulses coming through the atria.

In normal heart rhythm, electrical impulses cause the heart to contract thereby pumping blood out to the body. These electrical impulses start in the atria, and then pass through the AV node to the ventricles (lower chambers). The function of the AV node is to coordinate the contractions of the atria and ventricles. During AF, the AV node tries to deal with the chaotic electrical impulses coming from the atria but it can’t. The result is the ventricles also out of rhythm.

Treatment for AF is specific to each patient. To regulate Adelyne’s heart rhythm, Dr. Bird implanted a compact pacemaker—containing a battery and small computer—under her collarbone. A wire, or lead, connects the pacemaker to the heart. “The pacemaker acts as the ‘brain’ of the heart, and keeps the heart beating at a normal rate for her age and activity level,” Dr. Bird explains. “The pacemaker actually senses how much activity Adelyne is doing and adjusts her heart rate from 70 to 120 bpm as needed.”

In a separate procedure electrophysiologist Zalmen Blanck, MD, FACC, performed an AV nodal ablation. This procedure stops the irregular electrical impulses from traveling through the AV node. Adelyne’s new pacemaker now “paces” her heart’s pumping action.

“We have a full gamut of pacemakers from simple to complex and may include a built-in defibrillator that can diagnose a defect in heart rhythm and administer treatment,” says Dr. Bird.

So now when Adelyne’s heart beats a bit faster, it’s for all the right reasons. “I feel wonderful…a whole lot better. I can now do whatever I want to do. While I can, I’ll appreciate living and enjoy staying on the go,” says Adelyne.

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