A good heart that beat too fast

Brianna Huebner of Mauston, Wis. is a high school student, athlete, Sunday school teacher, heart patient. To look at this healthy, active teenager it's hard to believe she was suffering from supraventricular tachycardia (SVT)-episodes when Brianna's heart would race uncontrollably without warning or provocation.

"This is a fairly common condition, but it can still be very scary. Patients commonly describe it as "my heart feels like it's pounding out of my chest." While not in Brianna's case, the condition can also be life threatening," says Zalman Blanck, MD, FACC, a leading electrophysiologist who provides services at Gundersen Heart Institute. As an electrophysiologist, Dr. Blanck is a cardiologist with additional training in the diagnosis and treatment of abnormal heart rhythms.

"I was teaching Sunday school when my heart started to race," remembers Brianna. "When my heart did not slow down on its own my parents rushed me to Hess Memorial Hospital in Mauston, Wis. There, an EKG (electrocardiogram) showed my heart rate at over 200 beats per minute." This was more than three times her normal heart rate of about 60 beats per minute.

"Brianna's condition is caused by an extra electrical pathway in the heart," explains Dr. Blanck. "We all have a natural pacemaker in our hearts. This pacemaker sends electrical pulses out to the top chambers in the heart (the atria). The pulses then travel through a pathway to the lower heart chambers (the ventricles)."

Normally, a single pathway allows the pulses to travel from the atria to the ventricles. Some people, like Brianna, have an extra pathway. During an episode, the electrical pulses continuously loop around the two pathways. The heart, in effect, short circuits causing the rapid heartbeat.

Although physically active, exercise never triggered Brianna's racing heart. "SVT can start at any time, even while the patient is sleeping, and last for a few seconds or several hours. A patient with this extra pathway in the heart may have their first episode as an infant or not until old age…or never. Episodes may occur years apart or several in one week. It is very unpredictable," says Dr. Blanck.

Doctors at Hess Memorial were finally able to get Brianna's racing heart under control with medication. Brianna was then referred to Susan MacLellan-Tobert, MD, a pediatric cardiologist at Gundersen Heart Institute in La Crosse who also consulted with Dr. Blanck. "She knew right away what was wrong," recalls Brianna.

The only symptom of SVT Brianna had was the telltale racing heart, but other symptoms might include, lightheadedness, dizziness, fainting, chest pain or shortness of breath. If you have symptoms, you should do what Brianna and her parents did and seek medical help and, if necessary, the advice of a specialist.

Medications would control Brianna's SVT, but she would need to take them the rest of her life. And according to Brianna, the medication tired her out and as an athlete, affected her performance. So Brianna, her parents and doctors decided that surgery would be the best option.

About a month after the frightening episode in church, Brianna was wheeled into the Catheterization Lab at Gundersen's Heart Institute where Dr. Blanck and his team performed a catheter ablation.

In this outpatient, minimally invasive procedure, thin flexible wires were threaded up into the heart. Dr. Blanck stimulated Brianna's heart to induce the problematic electrical looping so they could pinpoint the extra pathway. Once located, he selectively destroyed the tissue responsible for the abnormal heart rhythm.

As an athlete, Brianna continues to race but her heart no longer does since her ablation. In addition to running, she enjoys tennis, basketball and just being a healthy teenager.

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