When
my co-workers heard that I had suddenly canceled a trip to Chicago where I’d
planned to install a radio station, they assumed that I must be dead. Turns out
that they were almost right.
In truth, I really wasn’t feeling well
at all. And when I finally got to my GP’s office, he offered me two options:
Option
#1: Go directly to the emergency room
Option
#2: DO NOT IGNORE OPTION #1
Seems that although I had been sitting
quietly in his office for 45 minutes before he checked my pulse, my heart was racing
at 165 beats per minute. That was way too fast, and based on the history he
took, he surmised that my heart probably had been beating at about that rate
for a month or more, putting me squarely in the league of a man in congestive
heart failure.
The good news is that any preliminary
diagnosis with “heart” and “failure” in it gets you to the head of the line at
the OR. And it was no time at all before the great triage team at Bryn Mawr Hospital
in suburban Philadelphia had an IV delivering a cocktail of drugs that had me
right back down to my good, old 68 bpm.
But it was the next morning when I got
the good news/bad news: While the proper dosage of beta blocker medication
could keep me at a healthy 68 bpm for a good long life, the list of potential
side effects was long and scary, especially for a man anxious to avoid any drug
therapy at all. And while my nurses assured me this was a great alternative —
considering, well, “the alternative” — I wasn’t so sure.
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A
3D cardiac map guides the surgeon by imaging each RF-administered ‘ablation’ made
to the heart muscle in this cross-section of the left atrium.
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Circuit
design
A normal heartbeat is regulated via a
complex and elegant on-board series of pacemaker cells that control the orderly
chemical depolarization and repolarization of the heart muscle. The messengers
are electrical impulses originated in the right atrium, which from this upper chamber
are conducted via heart fibers to the lower chamber ventricles, which have their
own pacing system that serves as a backup. When all is in sync, a healthy heart
displays the classic waveform: a “sinus rhythm” of standard waves, segments and
intervals. And the beat goes on.
But in my case, not so much. Pathways apparently
were misaligned, causing these signals to interfere and create an arrhythmia, so
that my heart constantly raced rather than beat at a normal rhythm and pace.
Enter
the radio doctor
Dr. Sheetal Chandhok introduced himself
to me as an “electrophysiologist and arrhythmia specialist” and asked if I’d
consider an “ablation.”
Yes, I had to ask what that was too. Seems
that over the last 15 years, a drug-free procedure had been developed and refined
in which a miniature electrode is inserted into the heart via a small catheter.
Once precisely in location, RF energy is used to create hundreds of tiny burns
or “ablations,” isolating the misfiring cells by creating an electrically
insulating barrier of scar tissue, thus stopping the transmission of the errant
electrical pulses and in most cases, the arrhythmia.
He asked if I was comfortable with this
high-tech “radio-wave” approach. I said, “Funny you should ask …”
“All-nighter”
Awaking the next morning in my hospital
room to a wonderful, drug-free 68 bpm, I learned that I had been under full
anesthesia and on the operating table for a startling 6-1/2 hours (cardiac
ablation normally takes just two to three).
Seems that the first set of 150
30-second RF pulses didn’t work. That is, the tenacious misfiring heart cells in
the upper chamber of my heart simply found another conductive pathway via different
muscle fibers to reach and confuse the lower heart chambers. And two hours and
another 150 scars later (each represented by a colored circle in the accompanying
3D image), the errant electrical signals again found a route to the ventricles,
this time by circling above to find yet a third pathway to undo my normal sinus
rhythm.
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The
author on an early morning run (again) on South Street in his native
Philadelphia.
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But my surgeon, too, was “tenacious”
(his word). I say, he’s a hero. Instead of going home to wife and child in the
wee hours of that Saturday morning and consigning me to the 5 percent of
patients for whom ablation is not effective, he kept at it.
Finally, a third set of 150 RF burns
around the top of the atrium did the trick and the circuit was repaired. So
that next morning (and every morning since), I awoke to a normal heartbeat.
The
heart of the matter
Does any of the above sound familiar? How
many of us radio engineers have spent late nights chasing a ground loop or oscillation
trying to return a piece of equipment to original factory specifications? And
while the motivation for our hard work, dedication and tenacity may not be as
laudable as saving a life, I write this article in the most profound
appreciation to every practitioner in every trade who embraces this spirit of excellence
and keeps their clients on the air.
For me, it’s just great to be back to full
effective radiated power.
Daniel
Braverman is president and founder of Radio Systems Inc. and now again enjoys easy
morning runs along the Delaware River near his home in downtown Philadelphia.
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