Dr. Devi Nair, electrophysiologist with Cardiology
Associates in Jonesboro and a member of the medical staff at St. Bernards, has
performed a procedure that is a first in Northeast Arkansas. She recently
performed an ablation procedure in a patient from Manila with Atrial
fibrillation to restore normal heart rhythm.
The procedure,
called Pulmonary vein ablation (also called pulmonary vein antrum isolation or
PVAI), is a treatment for atrial fibrillation, is now being done at St.
Bernards thanks to the construction of a new dedicated Electrophysiology
Laboratory (EP Lab) located in the St. Bernards Heartcare Center.
Nair successfully treated the 43-year-old
who suffered from atrial fibrillation – an irregular heart rhythm caused by
abnormal electrical activity in the upper left chamber of the heart (left
atrium).
A cardiologist with advanced training in treating heart
rhythm conditions, she used a catheter-based procedure to correct the patient’s
rapid heartbeat by destroying cardiac tissue that created abnormal electrical
signals. Nair works in conjunction with a highly trained team of EP lab staff
and anesthesia staff that assist her during the procedure.
Atrial fibrillation is the most common type of
arrhythmia (or problem with the rhythm of the heartbeat) and can affect people
of any age. It occurs when the upper chambers of the heart are fibrillating –
or “quivering” – and it causes a rapid, irregular heart rhythm.
The normal heart rate of an adult is between 60 and 100
beats a minute. But when the heart is in AFib, the atria can beat more than 300
times a minute, Nair explains. That irregular rhythm means the upper and the
lower chambers of the heart do not work together as they should.
The atrial fibrillation itself is not dangerous. But if
the condition is left untreated, side effects of AF can be life-threatening.
When the atria are fibrillating, the blood flow to the
lower chambers of the heart (ventricles) is slowed, and that increases the risk
of developing blood clots. If a clot were to break loose, it could result in a
stroke or a heart attack.
Another side effect of AFib is that it can cause the
ventricles to beat too fast, and over time, that can weaken the heart muscle
and lead to heart failure.
Because St. Bernards recently constructed a dedicated
Electrophysiology (EP) Lab in its Heartcare Center, the two
electrophysiologists on staff at St. Bernards – Dr. Devi Nair and Dr. Roosevelt
Gilliam – now have the most sophisticated tools at their disposal to treat a
wide range of heart rhythm problems.
In this instance, Nair used a catheter-based procedure
that allows her to locate the exact sites within the heart where abnormal
electrical activity is created in patients with atrial fibrillation. She then
was able to destroy the tissue that was producing abnormal signals by
cauterizing it using radio frequency energy.
In a lengthy procedure done under general anesthesia in
the EP Lab, Nair inserted catheters (long, flexible tubes) into the blood
vessels of the leg. Two of the catheters are guided into the left atrium
through a small hole made with a needle in the atrial septum (wall between the
right and left atria).
A transducer is inserted through one of the catheters so
intracardiac ultrasound can be performed during the procedure. The ultrasound
allows the doctor to view the structures of the heart and evaluate the position
of the catheters during the procedure.
A
catheter in the left atrium is used to find or map the abnormal impulses coming
from the pulmonary veins using a highly sophisticated 3D mapping system.
Another catheter is used to deliver the radiofrequency energy outside and
around the pulmonary veins, thereby destroying connections of the pulmonary
veins to the left atrium. Frequently, other areas involved in triggering or
maintaining atrial fibrillation are also targeted.
Nair
works closely with the anesthesia staff during this very lengthy procedure to
keep patients comfortable and safe. Her specially trained EP team includes
Jason Martin, Angela Ivy, Janet Chappell and Deanna Walker, who also work
closely with her during the entire procedure.
The highly specialized procedure is possible because of
an investment of approximately $2.5 million to create and equip a
state-of-the-art lab dedicated to EP procedures.
The AF ablation is only one of the procedures used by
St. Bernards electrophysiologists to treat heart patients from Northeast
Arkansas and Southeast Missouri right here so they don’t have to leave home to
receive world class care. Nair states that patients can get every procedure in
cardiac electrophysiology performed anywhere in the rest of the country right
here at St. Bernards.
In addition to the recent completion of the new EP Lab,
St. Bernards has upgraded its two Cardiac Catheterization Labs, raising the bar
for heartcare in the region and building on a heart program which was has grown
steadily since its inception three decades ago.
St. Bernards offers the most comprehensive heartcare
services of any facility in the region. It is the only medical center with
electrophysiologists on staff, and it is the only facility with a dedicated EP
lab.
St. Bernards is the region’s only medical center
designated as a Blue Distinction Center for Cardiac Care by Blue Cross Blue
Shield.
Nair completed her medical school in University of
Kerala in India. She earned her M.D. degree from Columbia University College of
Physicians & Surgeons in New York City at St. Luke’s Roosevelt Hospital
Center. She completed fellowships in Cardiology and Cardiac Electrophysiology
at Case Western Reserve University at MetroHealth Campus in Cleveland, Ohio,
and is board certified in Cardiac Electrophysiology, Cardiovascular disease and
Internal Medicine.
The first patient Nair treated at St. Bernards using
pulmonary vein ablation was Brandon Harper, a 43-year-old Manila resident who
was diagnosed with atrial fibrillation four years ago. He was treated with
medication, but by late last year the medicine was not controlling his symptoms
well.
So he and Nair discussed the pros and cons of the
ablation procedure. And he underwent that procedure in mid-April. “Now,” he
says, “I feel like my old self.”
Harper, who is a human resources manager at American
Greetings in Osceola, says he feels better than he has in four years. And he
feels like he has his life back.
Harper and his wife Jennifer have four daughters,
Chelsea, 15; Anna Marie, 8; Eva, 3; and Katie Beth, 6 months.