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After a life-threatening event in his childhood, Mark Metzl, MD, Cardiologist at NorthShore, knew he wanted to be a doctor. From watching someone save his brother’s life to saving the lives of others, Dr. Metzl discusses how his job can be very rewarding and very humbling.
Was there a particular moment of realization when you knew you wanted to go into medicine?
When I was about 10 years old, my brother Jonathan (who was about 8 at the time) had an asthma attack and couldn't breathe. We took him emergently to Highland Park Hospital and the team in the Emergency Department saved his life. He spent a few days at Highland Park Hospital before coming home. I decided at that young age that I wanted to have a job that positively impacted people and their loved ones in the ways that meant most to them.
What led you to cardiology as a specialty?
In the first two years of medical school, you learn how the body works and what could go wrong with each body system. Cardiovascular medicine, the way the cardiovascular system functions in concert to send blood to each part of the body, was amazing to me as a student and continues to inspire me. Cardiovascular disease is also one of the most heavily researched and well-understood components of medicine. We have so many methods of improving our patients' lives in cardiology, which makes it a very rewarding specialty.
What is your favorite thing about your job?
I love watching people get better. The most rewarding part of my job is seeing patients in the office before and after a cardiac procedure, hearing about the difference and improvement in their lives. It is a great motivator to come to work everyday.
What is most challenging about your field?
The most difficult part of our field is that there is still so much to learn. Our patients expect us to provide answers and sometimes there are none known. Cardiology, and specifically cardiac electrophysiology, is a very humbling field.
Can you explain what the lead extraction procedure is?
A lead extraction is when we remove a pacemaker or defibrillator lead (wire) from the body. We use the term, Cardiac Device Lead Management Program, rather than lead extraction for what we do because not all pacemaker and defibrillator leads referred to us should be removed. Each patient and each pacemaker/defibrillator lead is a unique clinical situation with its own associated risk and benefit--we have a personalized approach to each patient.
How can patients tell if something is wrong with their pacemaker? What should they do?
Patients should make sure that they follow up in the NorthShore Device Clinic at regular intervals and remember to see their cardiologist once a year. We have an excellent team that works tirelessly on our patients' behalf.
What do you think is the most important thing everyone should know to improve heart health?
I believe strongly that the most important things that we should all be doing everyday are exercise, eat more plants and find a way to manage the stress that we all encounter in life.
Dr. Metzl on a-fib innovations
How often do you see patients for atrial fibrillation? Is there a certain demographic that it is common in?A little more than half of the patients Heart Rhythm Specialists see have atrial fibrillation. AFib is a progressive disease and is more common as we get older. However, it often occurs in younger people too.What are some of the standard treatments for a-fib?The treatments of AFib fall into four main categories: stroke prevention, symptom relief, rhythm control, and decreasing AFib recurrence. Stroke prevention is often most important. We assess patients’ risk for stroke and discuss treatment options accordingly. There are anticoagulants and also new medical devices on the market that diminish stroke risk. There are medications and also procedures, such as ablation, that allow patients to feel better, to stay in normal rhythm, and to prevent AFib recurrence. Finally, there are several important complimentary issues to address, such as exercise, weight loss, and blood pressure control, assessment of sleep apnea, thyroid disease, valve disease, and stress reduction.Do all patients diagnosed with a-fib require surgery? How do you decide? A small fraction of patients with AFib will require surgery. We are a comprehensive center for AFib and discuss the many options available to our patients in detail. It’s not a one size fits all problem—we are passionate about personalizing care for AFib.How has the diagnosis and treatment of a-fib developed over the years?We are lucky to live in a technologically driven world. Diagnosis of AFib has greatly improved over the last few years and will likely continue to do so. We often use patch monitors that look like a band-aid to detect arrhythmia. Many of our patients are using their own smartphones for diagnosis. There are current efforts underway to use electronic “wearables,” such as the iWatch, to better detect AFib. Treatment has also greatly improved. Procedures to reduce the risk of stroke and recurrent AFib have become more effective and safer.What are some of the innovations the team at NorthShore has implemented to treat a-fib?The CVI at NorthShore is at the cutting edge of diagnosing and treating AFib. We have helped develop ablation technologies to improve procedure outcomes. We are developing integrated AFib clinics to improve our ability to treat the complexities of AFib patients. We believe that our team approach to AFib allows us to provide better care.Can you tell us about the new pacemaker technology, like the Micra wireless pacemaker? What are the benefits of this technology/how have they changed the treatment process?For patients with permanent AFib and slow heart rates, the Micra wireless pacemaker, has been a major technological development. The pacemaker is the size of a large pill and is implanted directly in the heart without surgery (via a venous catheter). The long-term risk of having pacemaker wires is non-existent for patients with this device. We are among the national leaders in Micra pacemaker implantation.Are there any research studies going on at NorthShore focusing on a-fib? We have several studies focusing on patients with AFib, but I would like to point out two really important ones. We are participating in a study looking at the benefit of cryo-balloon ablation in patients with persistent atrial fibrillation. This is the first study looking prospectively at ablation in this patient population. We are also participating in a study for the Watchman device, which occludes the left atrial appendage to lower the risk of stroke, in patients that cannot take blood thinners for even a short amount of time.