A St. Bernards physician who specializes in treating heart rhythm problems, has become the first electrophysiologist in Arkansas to use new technology approved by the U.S. Food and Drug Administration to restore normal heartbeat for a specific kind of heart condition. And in the process, Dr. Devi Nair has given one Jonesboro patient her life back.
Betty Smith has been suffering from a condition known as atrial fibrillation for a number of years. She … like most patients with atrial fib … was treated with medication to control symptoms that included a very fast and abnormal heartbeat. She describes the episodes as times when her heart was “racing,” pounding so fast that it felt as if it would burst.
Over time, her symptoms grew worse, and episodes grew more frequent. It became a life-changing problem, with Smith hesitating to get far from home. Even with adjustments to her medications, she could not lead what most would consider a normal life. She always was worried about her heart problems, and because she knew that a fib placed her at a higher risk for stroke, she lived under a constant cloud concern. There is a history of strokes in her family, and she has seen first hand how devastating they can be.
The normal heart rate for an adult is between 60 and 100 beats per minute, explains Nair, an electrophysiologist at Cardiology Associates who is on the medical staff at St. Bernards. But what happens to people with atrial fibrillation is the atria – the top chambers of the heart – beat erratically up to 300 times a minute, keeping the upper and lower chambers of the heart from working together as they should.
Nair says that the atrial fibrillation itself is not dangerous, but if the condition is left untreated, side effects can be life threatening. “When the atria are fibrillating, the blood flow to the lower chambers of the heart – the 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 heart attack.
“Another side effect of a fib is that it can cause the ventricles to beat too fast and over time, weaken the heart muscle, leading to heart failure,” Nair continues.
There are treatments that can eliminate symptoms and correct the heart rhythm, Nair says, adding that such treatments involve destroying heart tissue responsible for creating abnormal electrical signals that make the upper chambers of the heart quiver or beat rapidly. One of the two primary techniques uses heat (radio frequency ablation), while the other uses cold (cryoablation). Both can be done as catheter-based procedures in the region’s only electrophysiology (EP) lab at St. Bernards.
“Mrs. Smith was a very good candidate for a treatment that enabled us to use new catheter-based technology recently approved by the FDA and owned by Medtronic,” Nair said. “It is called cryoballoon ablation for atrial fibrillation.”
Typically, the source of electrical signals that cause the irregular heartbeat in atrial fibrillation is in the area of pulmonary veins.
The new technology Nair used to treat Smith is called Arctic Front Cryoballoon ablation, and it uses a catheter device with an inflatable balloon. The catheter is inserted into a blood vessel in the leg and maneuvered by the physician into the left atrium of the heart. When in place, the balloon is inflated, sealing off the opening of the pulmonary area, and a refrigerant is delivered to the tissue all the way around the opening, thus freezing it and disabling the unwanted signals.
The procedure has dramatically improved the life for Smith, she says. And both the patient and physician are pleased with results. Nair expects to be able to eliminate the medication Smith has been on to help regulate her heart rhythm completely over the period of 3-6 months. Though it can take a matter of months to determine how successful the treatment is for any patient, Smith already is enjoying the freedom that improvements have made in terms of lifestyle. And she looks forward to being able to travel soon to visit her daughter who lives out of state.
Atrial fibrillation is a form of irregular heartbeat that affects about 3 million Americans, and it is the most common heart rhythm problem.
Presently St. Bernards is the only hospital in Arkansas at which this new technology is being used. The cryoballoon ablation is the newest of several tools St. Bernards electrophysiologists have for improving the lives of patients with atrial fibrillation. Atrial fibrillation 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. As a matter of fact, patients can get every procedure in cardiac electrophysiology performed anywhere in the rest of the country right here at St. Bernards.
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 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 has grown steadily since its inception three decades ago.
Dr. 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. She has been on the medical staff at St. Bernards for approximately a year.
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. It is the only medical center in the state offering the Artic Front Cryoballoon ablation catheter technology for atrial fibrillation. St. Bernards also is the only medical center in the region designated as a Blue Distinction Center for Cardiac Care by Blue Cross Blue Shield.