Doctors Unravel ‘Most Complicated Heart Case’ – Twice
For more than 20 years, Sally Robinson has dealt with heart issues. They started in her mid-40s, when she became faint at an outdoor event. She didn’t think much of it, until a few months later, as other symptoms began to appear.
Symptoms of Enlarged Heart Lead to ER Visit
“I started feeling really tired,” Robinson recalls. “I’d wake up absolutely drenched with sweat. That’s when I decided to see my doctor. She did an EKG and said my heartbeat was ‘all over the place,’ so she sent me to the ER.”
Todd Langager, MD, cardiologist with UnityPoint Health – St. Luke’s Heart Care Clinic, was involved with Robinson’s case from the start.
“She was found to have an enlarged and weakened heart,” he describes. “While she was undergoing evaluation, she had a dangerous heart rhythm called ventricular fibrillation – a chaotic, heartbeat in the lower, larger chambers of the heart.”
Implantable Cardioverter Defibrillator Procedure Completed
Dr. Langager recommended an implantable cardioverter-defibrillator (ICD), which monitors and shocks the heart if it detects a life-threatening rhythm. Normally an ICD procedure is done in a single setting, but Robinson’s heart is complex and required several procedures.
“It was the most complicated heart case and the most challenging ICD implant I’ve had in over 30 years of medicine,” Dr. Langager says. “Ms. Robinson went through it without any major complications. She’s done very well over years; that’s a testament to everyone who cared for her.”
Fast Forward 20 Years: Holter Monitor Reveals Afib Issues
An ICD has limited battery life, sometimes lasting as little as five years. Robinson’s made it nine years and required a replacement in 2013. Besides the new ICD, she had no other incidents until 2023, when she experienced similar symptoms as her first heart event.
“I was tired; I felt like I could sleep half the day, and I didn’t have enough energy for my usual activities,” Robinson shares. “I went to St. Luke’s cardiology again, and saw Dr. Halawa (Subhi Halawa, MD, interventional cardiologist). He ordered an EKG and had me wear a Holter monitor.”
A Holter monitor is a device worn for 24-48 hours to record heart patterns and identify concerns. Robinson’s monitor showed unusual heart rhythm (Afib). As a result, Dr. Halawa connected her with another St. Luke’s cardiologist, Talha Farid, MD, (EP), electrophysiologist, a specialist who treats electrical problems of the heart.
“Ms. Robinson has cardiomyopathy, heart disease that weakens the bottom chambers of the heart. That means it must work harder to pump blood to the rest of the body,” Dr. Farid explains. “This time, the issue, Afib, was affecting the top chambers of the heart. For her it was more serious and challenging, because of her preexisting heart condition.”
Treatment options for Afib include medication therapy, cardioversion (electrical shock to restore regular heartbeat) and ablation (surgical procedure that destroys the tissue causing irregular rhythm). Robinson required all of these.
“Cardioversion is more of a ‘temporary’ treatment,” Dr. Farid says. “Most of the time it’s used as a bridge to either long-term medical therapy or a more definitive therapy like ablation. We discussed all the options and ultimately performed an ablation, as well as started medical therapy. This combination has worked well for her.”
Twice the Capacity Means Faster Afib Treatment at St. Luke’s
Dr. Farid says Afib is one of the most common heart conditions. Thanks to St. Luke’s Heart and Vascular Expansion, more patients can receive treatment for Afib, and sooner. The project included a second EP lab and upgrades to the existing space, doubling St. Luke’s capacity for procedures such as ablation.
“Across the country, the wait time for an EP procedure can be anywhere from two to eight months,” Dr. Farid says. “With our new labs, we can perform an ablation in a couple of weeks.
“I can’t stress enough that patients see a cardiologist as soon as possible if they have Afib,” he continues. “Data suggests the earlier the intervention, the better the outcomes. The best time for an ablation is early in the disease process; that’s when it offers the maximum benefit.”
With Robinson’s many years of heart care, she knew the importance of seeing her cardiologist as soon as she noticed symptoms. She has been pleased with the care and dedication she’s received from St. Luke’s Heart Care team and continues to keep in close contact with them to monitor her situation.
“I’m grateful to have heart care close by,” she says. “I feel fortunate to be in an area with topnotch cardiology facilities, and I’ve been very pleased with St. Luke’s cardiologists. It’s more personal. They take time to listen, and they know what’s going on. St. Luke’s cardiology team is always watching what’s cutting-edge.”
For more information visit St. Luke’s Heart and Vascular Services. To connect with a cardiologist, call St. Luke’s Heart Care Clinic at (319) 364-7101.