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Arresting AFib

Monday, November 27, 2017 9:01 AM

Typically fit and healthy, Michael Patoff was surprised when he developed severe shortness of breath last summer. His allergist’s first hunch was that it might be related to Patoff’s ongoing asthma or an inflamed lung. But the symptoms seemed much more intense, and the rapid onset left him barely able to walk a few feet without having to stop and rest.


Expert Diagnosis
As the condition worsened—even on medication—the 66-year-old from Glenview did not waste any time contacting his NorthShore Internist Jonathan Brown, MD. “Dr. Brown took one look at me and said ‘I think you’re in big trouble,’” Patoff recalled. “He sent me to the Emergency Department at Glenbrook Hospital. If Dr. Brown hadn’t caught it, I wouldn’t be alive today. I would be on the other side of the lawn.”

Once stabilized, experts at NorthShore Cardiovascular Institute properly diagnosed Patoff with acute heart failure and an abnormal heartbeat due to atrial fibrillation—or AFib—a serious rapid, irregular fluttering rhythm within the chambers of the heart.

What turned it around, Patoff said, was the quick response and innovative treatment plan from a “phenomenal team at NorthShore.” His cardiac care team included heart failure expert and Cardiologist Robert Gordon, MD; Electrophysiologist Mark Metzl, MD; and Cardiac Surgeon Hyde Russell, MD.

“This team is unbelievable. I call them the dynamic trio,” Patoff added. “They saved my life!”

Leading-Edge Intervention
Dr. Gordon, who holds an academic title at the Pritzker School of Medicine, initially worked to ease Patoff’s symptoms, including the labored breathing, by prescribing medication to help address fluid build-up that was taxing his overall heart function. Meanwhile, Drs. Metzl and Russell were preparing for a novel hybrid procedure to treat Patoff’s AFib through a combination of electrophysiology—adjusting the heart’s intricate electrical system—and minimally invasive surgery.

“It’s a new treatment that Mark and I are championing, which is not available at many health systems and can benefit patients with this kind of life-threatening condition,” explained Dr. Russell.

The procedures are performed in the electrophysiology lab, where NorthShore has sophisticated equipment to draw so-called “voltage maps” of the heart to track the precise location of the AFib’s origin. Working as a team, Dr. Metzl positions catheters into the heart, while Dr. Russell makes a small incision to place a surgical instrument and tiny camera outside the heart, in the pericardial space—the sac of fluid that holds the heart in place.

Keeping the Beat
“Using our voltage maps as a guide both outside and inside the heart, we are able to ‘quiet’ or eliminate the AFib by using a technique called catheter ablation,” said Dr. Russell. The catheter—or thin tube—uses radiofrequency to destroy the abnormal tissue creating the disorganized electrical signals behind the rapid, irregular heartbeat. “We track our progress by referencing the voltage maps until all the abnormal cells on the outside of the heart are ‘quiet’ and no longer causing AFib.”

Dr. Metzl then uses the same ablation technique on the inside of the heart, to eliminate any abnormal tissue and restore regular heart rhythm from within.

“It’s a very technically advanced procedure and requires a team approach, as neither of us can do it alone,” noted Dr. Metzl, who holds an academic appointment at the University of Chicago Pritzker School of Medicine. “NorthShore is truly leading this innovative technique in a direction that no other medical centers are doing currently.”

A Grateful Heart
Now in cardiac rehab, Patoff also was implanted with a defibrillator pacemaker to further control his heart rhythm. In the months following the procedure, he is quick to express gratitude for both the technology and his care team who used it so effectively to improve his health.

“This is the most innovative team out there,” he said. “Each physician has his own specialty and they work in sync. I feel great again. I’m stronger, and I can breathe and walk around with no problems.”

As he moves forward with recovery, Patoff savors time with his wife and their 28-year-old daughter, noting how family and friends helped him throughout his ordeal with love and humor.

“This episode puts life into perspective. I value how precious each moment has become and I’m thankful every day for this second chance.”