As maintenance supervisor at a hydroelectric plant
in Monroe, Ronnie Steeves was used to working
long days outdoors in all kinds of weather,
moving scaffolding and equipment and being on the go.
He hadn’t taken a sick day for nearly 12 years. Slowing
down wasn’t part of his personality.
So in 2008, at the age of 47, when his energy level suddenly
dipped, he noticed—but chose to ignore it. “At first, I didn’t
pay much attention to it,” remembers Ronnie, who commutes
to work from Orange, where he lives with his wife
and teenage children. “I thought I was run down or tired
from working too much.” Weeks passed and he tried to get
more sleep, but the fatigue didn’t let up. “I tried to shake
it off,” he says. “I thought maybe I was out of shape or it
was just part of getting older.”
His wife, Lorri, sensed something wasn’t right about her
husband’s health. “My wife was on me all the time to see
my doctor,” Ronnie says. “I was stubborn about it for
a long time. I usually go about once a year anyway, and
I had checked out just fine at the last one, so I wasn’t
concerned about ‘feeling tired.’” But when Ronnie couldn’t
even take a few steps without feeling winded, he knew it
was time to see the doctor.
Primary care physician Paris Spanolios, MD, tested
Ronnie’s heartbeat in the office. The painless electrocardiogram
took just a few minutes. (An electrocardiogram—
ECG or EKG—measures the patterns or rhythms of the
heart. A doctor can interpret the patterns to diagnose various
The electrocardiogram results indicated a serious problem
with Ronnie’s heart: he had atrial fibrillation (AF) which
had triggered congestive heart failure (CHF). (See below:
Shortness of Breath, Fatigue and CHF.)
What’s Atrial Fibrillation (AF)?
Affecting millions of adults in the United States, AF is a
serious heart condition, resulting in an irregular heartbeat.
Shortness of Breath, Fatigue and CHF
Feeling winded and tired? It could be congestive heart failure (CHF). The first clue for many people with CHF is
shortness of breath. This breathlessness is because fluid has backed up into the lungs. Other symptoms include swollen
ankles and rapid weight gain (water retention), dizziness and fatigue.
Heart failure is due to either a weak heart muscle that’s not pumping correctly or, as in Ronnie’s case, the heart’s inability
to fill its pumping chambers with blood. CHF is caused by a wide variety of heart problems, such as a heart attack, high
blood pressure or a heart valve problem.
“If you find yourself out of breath, or if you’re at all worried about your breathing patterns, you should talk to your
primary care physician as soon as possible to get checked out,” says cardiologist Edward Tuohy, MD. “If it’s your
heart, the sooner the better, so we can get a jump on getting it fixed. Don’t wait.”
Abnormal electrical signals in the heart’s upper collecting
chambers cause the heart to quiver and shake, and may
affect its ability to pump blood. “Blood pools in the upper
chambers of the heart, due to inefficient contractions, and
blood clots can form,” says Chief of Cardiology Stuart
Zarich, MD. “These clots can travel from the heart
to the brain and cause a stroke.” Symptoms of AF often
come and go and include dizziness, shortness of breath and
palpitations (an unpleasant awareness of the heart beating).
Many people with AF also feel very tired. “Additionally,
many patients with AF have no symptoms at all,” says
Dr. Zarich. “It’s important, therefore, to learn to take your
pulse to see if you have an irregular heartbeat or if you are
at risk for AF.” (See: Could You Develop AF?)
“When my doctor told me I had atrial fibrillation, I got
really nervous,” Ronnie admits. “I never thought I’d have
a heart problem. Dr. Spanolios answered my questions
about what to do next. And when I got home, I also called
my sister Eileen, who’s a nurse, to find out more.”
Dr. Spanolios referred Ronnie to cardiologist Edward
Tuohy, MD, and cardiac electrophysiologist Murali
Chiravuri, MD. They prescribed a combination of treatments
to steady the beat of Ronnie’s heart. “Steadying or
restoring the heart’s normal rhythm is called cardioversion,”
says Dr. Tuohy. “In general, there are two ways to
do this: through medication or via a quick electric shock
to jolt the heart back into regular rhythm. With most
patients, we try medication first, but it depends on the
severity of their condition when they are diagnosed.” The
electrical cardioversion is done in the Connecticut
Cardiac Arrhythmia Center in the Heart Institute at
Bridgeport Hospital with the patient under anesthesia
(sedation). A cardiologist, nurse and anesthesiologist are
at the patient’s side to monitor his or her breathing,
blood pressure and heart rhythm during the procedure.
“When both treatments are used together, the medications
can usually maintain the rhythm the electric
cardioversion re-establishes,” he says.
When choosing a cardiologist or cardiothoracic surgeon, be sure to select an expert
physician affiliated with Bridgeport Hospital:
S.M. Yousuf Ali, MD
Doron Amir, MD
Linda Casale, MD
Murali Chiravuri, MD
Mitchell Driesman, MD
Anthony D’Souza, MD
Robert Fishman, MD
Leonid Karpenos, MD
Steven Kunkes, MD
Gilead Lancaster, MD
Michael Logue, MD
Adolfo Luciano, MD
Stephen Marshalko, MD
Craig McPherson, MD
Jay Meizlish, MD
Robert Moskowitz, MD
Randolph Panetta, MD
Edward Pinto, MD
Martin Plavec, MD
Adam Schussheim, MD
Boris Sheynberg, MD
Richard Taikowski, MD
Joseph Tiano, MD
Edward Tuohy, MD
Robert Winslow, MD
Stephen Woodworth, MD
Stuart Zarich, MD
Umer Darr, MD
Michael Dewar, MD
M. Clive Robinson, MD
Richard Salzano, MD
Kieve Berkwits, MD
Christa Miliaresis, MD
If you would like more information about, or a referral to, any of these expert physicians,
please visit www.bridgeporthospital.org/FindPhysician or call 1-800-794-5013, toll free, 24/7.
The doctors recommended a combination of treatments to
regulate Ronnie’s heart rhythm. “For about a year, I was
taking three medications daily,” he remembers. “I also had
the electrical cardioversion at Bridgeport Hospital three or
four times. My heart would hold up for a while, but
then it would go back in to AF.”
“The cardioversions would temporarily
regulate Ronnie’s heartbeat, but neither
electrical nor medical treatment would
sustain it for more than a few weeks,”
says Dr. Tuohy.
Bridgeport Hospital is the only hospital in the area that provides radiofrequency ablation for cardiac arrhythmias.
To improve Ronnie’s quality of life, his
team of cardiac specialists explained a third
option: radiofrequency ablation, or RFA.
Radiofrequency Ablation (RFA)
“This minimally invasive procedure is a very effective way
to restore a heart’s rhythm,” says Dr. Chiravuri. “If we’ve
tried the other methods first and they were not successful,
RFA is a viable option.”
During RFA, which is also known as electrophysiology
(EPS) ablation, thin flexible tubes (catheters) are threaded
into a blood vessel that reaches the heart. A burst of highfrequency
electrical energy is delivered to block or redirect
the areas of the heart impulse that are causing the irregular
heartbeat or rhythm.
On an early Monday morning in May, accompanied by his
wife and sisters, Ronnie went to the Heart Institute at
Bridgeport Hospital for the RFA procedure.
“I was under anesthesia, so I was sort of
out of it, but Dr. Chiravuri and the nursing
staff were great. They treated us
well, answered our questions and made
sure we were comfortable,” says Ronnie.
After just one night in the hospital, he
was ready to go home. “I noticed a difference
right away,” he says. “That morning,
the nurses asked me to walk, to prove I
was really better,” he says.
Thanks to the experts in the Heart Institute at Bridgeport Hospital, Ronnie Steeves’ heart is back in rhythm.
He was back at work in less than a week. “It was tough to
take those few days off to recover—remember, I had perfect
attendance—but I knew I had to take it easy,” he says.
Back on the Job
Today, Ronnie is grateful to his doctors for fixing his heart.
He also thanks his wife for pushing him to get checked.
“When I was first diagnosed, it was difficult to think about
my future. I didn’t know what was going on with my
heart, and I couldn’t imagine my life changing,” he says.
“I am so thankful to my doctors. And, I feel great. I can
golf again and walk up stairs without feeling winded. Best
of all, I’m back at work!”
A Fourth Option for Atrial Fibrillation (AF): MiniMaze
Bridgeport Hospital Chief of Cardiothoracic Surgery M. Clive Robinson, MD, is one of only a handful of surgeons in
the country who performs an innovative minimally invasive heart procedure called MiniMaze. His experience includes
being a preceptor, teaching other surgeons how the MiniMaze can correct atrial fibrillation.
The procedure requires a team of specialists—Dr. Robinson, an electrophysiologist, anesthesiologists, nurses and
physician assistants. In the operating room, Dr. Robinson makes several small cuts between a patient’s ribs and inserts
a tiny camera to magnify his view of the heart. The electrophysiologist then maps the electrical impulse in the heart
to pinpoint the areas where the currents are not flowing properly. Using a specially designed clamp that sends out a
radiofrequency current, Dr. Robinson creates lines of scarring (ablations) to block the irregular impulses. As part of
the operation, Dr. Robinson also closes off the atrial appendage, a small sac-like structure on the outside of the heart,
in which blood collects, so no pooled blood can clot, travel to the brain and cause a stroke.
Could You Develop AF?
According to the American Heart Association, 2.2 million Americans suffer from atrial fibrillation (AF),
one of the leading causes of stroke.
- Age, especially those over age 65
- High blood pressure
- Heart disease, including heart attack, valve problems and previous heart surgery
If you’re concerned about your risk, speak
with your doctor. For an expert physician
affiliated with Bridgeport Hospital,
please call 1-800-794-5013.