Skip to Content
Due to a recent surge in pediatric RSV and flu, we are allowing only visitors 18 years of age and older in our general inpatient (hospital) settings at this time for the safety of our patients, in line with Illinois Department of Public Health guidance. Read More

NorthShore’s online source for timely health and wellness news, inspiring patient stories and tips to lead a healthy life.

Healthy You

Customized Cardiac Care: Minimally Invasive Surgical Team Gets Creative to Treat Complex AFib

Wednesday, February 02, 2022 1:04 PM

By: Susan J. White

Elizabeth Bhatt has overcome an array of serious health challenges in her seven decades, yet she perseveres with a positive attitude and tremendous faith. So when Bhatt was confronted with a threatening heart condition, she had full confidence she would prevail once again.

And she has, thanks to a team of specialists at NorthShore Cardiovascular Institute. They pushed the envelope in her treatment using an innovative procedure—with additional customization—to bring her atrial fibrillation (AFib) under control.

Advanced Implant
AFib is a heart rhythm disorder that can lead to increased stroke risk. Since Bhatt’s own father was debilitated by a stroke, she was determined—along with her care team—to ensure she would not suffer a similar fate.

After a consultation with NorthShore Electrophysiologists Jose Nazari, MD, and Mark Metzl, MD, it was clear that Bhatt was a good candidate for a device called a WATCHMAN, which is implanted in the top left chamber of the heart to prevent blood clotting without the use of blood thinners.

But the 77-year-old Bhatt of Skokie, who was born with severe arthritis and has a completely fused neck and spine, was not a candidate for the traditional WATCHMAN procedure. Her rigid anatomy prevented the use of an ultrasound probe through her esophagus for real-time imaging to properly position the implant.

Tailored Treatment
Drs. Nazari and Metzl were determined to accommodate Bhatt’s special needs, consulting with other subspecialists across the country to find an alternative imaging technique to help implant the device given these unique challenges.

“Dr. Nazari was so positive and confident they could do the procedure different way,” recalled Bhatt. “I wasn’t scared at all.”

So in April 2021, Bhatt became the first NorthShore patient to be implanted with WATCHMAN using an intracardiac echo—a unique imaging approach that provides real-time visuals of the heart via a catheter passed through the bloodstream instead of the esophagus.

“We were able to use techniques familiar to us in the Electrophysiology Lab that combined the probe with 3D mapping techniques for perfect placement,” explained Dr. Nazari.

Outstanding Outcome
“It went really, really well,” noted Dr. Metzl, who along with Dr. Nazari partnered with a third interventional cardiologist Jonathan Rosenberg, MD, to perform the procedure. It went so well, in fact, that the trio has used this same technique on dozens of other patients who benefit from the less invasive imaging that also requires less anesthesia. All three physicians hold academic appointments at the University of Chicago Pritzker School of Medicine.

“When I woke up after the procedure I didn’t even feel like anything had been done,” said Bhatt “Nothing bothered me and I felt great! The nurse came to me and said ‘you made history.’”

“The Watchman implant protects Elizabeth from a stroke and eliminates the need for blood thinners, which are problematic for her,” explained Dr. Nazari.

“Nothing stops her. Elizabeth has a strong mind and a strong spirit,” said Bhatt’s husband Yashivant or “Ashi”, who has been at her side for close to 50 years. “She wanted to get better, and get back to keeping everything in order at home.”

A meticulous housekeeper and gardener, Bhatt is known to pick up every stray leaf by hand in her yard, and wouldn’t dream of leaving the house without her hair done perfectly, joked her spouse. His devotion to his wife and gratitude for her doctors is clear.

Connecting Our Best For You
“Every doctor and every nurse was nice and helped explain everything so well. It all went so smoothly and we have absolutely no complaints,” he added.

“This was one of those times where we had the right family for the right circumstance,” said Dr. Nazari. “We were able to explain things to the Bhatts and they could visualize how this would make her life so much easier. We’re fortunate as doctors that we can help people in this way.”
Both Drs. Nazari and Metzl also stressed the collaborative nature of the specialized care offered through NorthShore Cardiovascular Institute and the AFib program.

“It’s gratifying as a physician to be on a team that truly works together to improve patient care. NorthShore encourages collaboration and puts resources into programs that lead to better outcomes for our patients,” said Dr. Metzl.