Why do surgeons from Long Island and Albany
travel to Bridgeport Hospital? (Hint: It’s not for the
palm trees!) Physicians choose to bypass dozens of
other hospitals along the way for the expert training
provided by Bridgeport Hospital Chief of
Cardiothoracic Surgery M. Clive Robinson,
MD. Dr. Robinson is one of only a handful
of surgeons in the country who performs
an innovative minimally invasive heart
procedure called MiniMaze. Because of
his expertise, Dr. Robinson is a preceptor,
designated to teach other surgeons
how the MiniMaze can correct a condition
called atrial fibrillation.
Atrial fibrillation patient Howard Chess, 59,
traveled 1,400 miles from Fort Lauderdale, Florida,
early last year to meet with Dr. Robinson and electrophysiologist
Craig McPherson, MD. (An electrophysiologist
is a cardiologist who specializes in treating heart rhythm
disorders.) Howard credits them for giving him a second
chance to live the life of his dreams.
He Never Suspected A Problem
Until one fateful day in November 2006,
Howard never suspected he had a heart
condition. He and his wife, Carol,
were happy with their busy lifestyle.
He loved his position as an administrator
for a non-profit organization,
the trips to Europe he and Carol took
together, and their active social life
with friends and family. Howard was at
the top of his game.
Howard especially looked forward to his early
morning workouts on the treadmill to jump-start his
day. But one morning, his routine came to a screeching halt.
Soon after starting his daily run, he suddenly felt dizzy. The
treadmill heart monitor read his pulse at 160—way over
the usual rate of 120, which was typical for him during a
workout. "I’m not going that fast," he thought. "I’m not
even breaking a sweat." Assuming the monitor was broken,
he got off and reset it. But the monitor continued to measure
his heart at the same accelerated rate. Thinking his
dizziness might be due to low blood sugar, he decided to
get off the machine and head to work, where he ate breakfast
at his desk.
But the dizziness didn’t subside, and he felt a strange fluttering
in his chest. Howard called his primary care physician,
who recommended that someone drive him to the
doctor’s office to get it checked out right away. Howard’s
condition was quickly confirmed: atrial fibrillation.
Watching and Waiting
Affecting millions of people, atrial fibrillation is a serious
heart condition. Abnormal electrical signals in the heart’s
upper chambers cause the heart to quiver and shake,
affecting its ability to pump blood. Blood then pools in
the upper chambers of the heart and can form clots. Clots
in the heart can travel to the brain and cause a stroke.
Symptoms of atrial fibrillation can come and go, and
include dizziness, shortness of breath and palpitations (an
unpleasant awareness of the heart beating). Many people
with atrial fibrillation also feel very tired. This is caused
by the decreased amount of blood being pumped by the heart each minute, as well as the weakening of the heart,
due to the constant racing of the muscle.
Howard’s doctor prescribed medication to control the
heart’s rate and rhythm, and instructed him to return in the
morning if symptoms continued. The doctor also prepared
Howard for the possibility of a cardioversion – a procedure
that delivers an electric shock to jolt the heart back to a
All night long, Carol kept vigil over her husband, worrying
about Howard’s heart palpitations, which continued at a
frightening rate. Howard’s doctor called throughout the
night to check on his condition. At daybreak, shaken from
the seemingly long hours at home, Howard and Carol headed
to the hospital, where the cardioversion was performed.
During the next few months, despite the medication and
the cardioversion procedure, Howard’s atrial fibrillation
symptoms continued. "I would feel fluttering in my chest,
or my heart pulsating—beating very hard," he says. "But
most of all I would feel very tired." The fluttering and pulsating
sensations would last anywhere from four to 12
hours. Medications helped relieve symptoms, but didn’t
stop them completely, and possible side effects of the various
medications weighed on his mind.
This waiting and worrying about having a stroke at any
moment didn’t allow Howard to relax and enjoy life as he
used to. "Atrial fibrillation knocked me off my lifestyle," he
says. "I wasn’t ready for this. I was only 59, and I wasn’t
willing to throw in the towel."
What is atrial fibrillation?
Atrial fibrillation is an abnormal heart rhythm. The
upper chambers (right and left atria) are stimulated
so rapidly that they stop pumping blood and simply
quiver (fibrillate). The condition can come and go
and is brought on by various triggers.
- Risk Factors: Previous heart attack; additional
heart conditions; high blood pressure; diabetes;
overactive thyroid; lung disease; high
levels of caffeine, stimulants or the body’s
own adrenaline. In many patients, there is no
obvious sign of heart disease or other risk factors.
Some patients have an inherited tendency
for atrial fibrillation.
- Signs: Dizziness, extreme fatigue, shortness of
breath, a fluttering sensation in the chest.
- Risks if Untreated: Blood clots leading to stroke;
enlargement of the heart leading to congestive heart failure (when the heart cannot pump
enough blood to the body’s other organs).
- Treatments (individualized, based on
a patient’s unique condition):
- medication to control the heart’s
rhythm and/or rate
- cardioversion – electrical shock
- catheter ablation – catheter inserted
into the veins of the groin, shoulder
and/or neck and guided to the malfunctioning
area of the heart to ablate or
destroy misdirected electrical pathways
- traditional open-heart surgery
- minimally invasive surgical ablation –
Howard began to explore alternate ways to treat his atrial
fibrillation. Due to other health conditions, he wasn’t a
candidate for anticoagulant medication (blood thinners) or
catheter ablation. (See "What is atrial fibrillation?," on previous
page.) Howard wasn’t completely comfortable with
pursuing the traditional open-heart surgical option, which
involves an extensive operation and stopping the heart
during the procedure.
Luckily, Howard’s brother, David Chess, MD, a physician in
Shelton, CT, was familiar with the successes of the team of
heart experts in the Heart Institute at Bridgeport Hospital.
He recommended that Howard fly up to discuss minimally
invasive surgical ablation for atrial fibrillation with Drs.
McPherson and Robinson. Howard was relieved to learn how
much less-invasive the MiniMaze procedure is, and agreed
that his health was valuable enough to make the trip north.
From the specialists, Howard found out that he had paroxysmal
atrial fibrillation, meaning that he had relatively brief
episodes of the palpitations and other symptoms. In addition,
Howard’s heart chambers had not yet become irreversibly
enlarged, so he was a good candidate for the