New lab at St. Elizabeth’s aims to help patients with irregular heartbeats

Thanks to $2.6 million worth of equipment in a new lab at the Prairie Heart Institute at St. Elizabeth’s Hospital in Belleville, Dr. Paban Saha is able to perform complicated procedures to treat an entire spectrum of heart arrhythmias — an irregular heartbeat — and implant cardiac devices, which help patients with atrial fibrillation.

Saha, an electrophysiologist with Prairie Cardiovascular Consultants, said the state-of-the-art equipment allows patients to experience a higher-than-normal rate of success.

The new $2.6 million Electrophysiology Lab will open its doors to the community for a behind-the-scenes look on Friday.

“For patients who have failed other forms of therapy for A-Fib, an ablation in our new EP Lab can significantly improve quality of life,” said Bonnie Schneider, director of Heart and Vascular Services at St. Elizabeth’s. “We truly are privileged to be able to provide these complex procedures for our patients.”

The new lab officially opened in the spring, but Saha started doing the procedures in September when most of the equipment was available for use.

John Enzwiler, 66, of Trenton was the first patient to undergo the procedure on Sept. 11. He said there were more than two dozen individuals in the room during the procedure. “It was quite an ordeal,” he said with a chuckle.

The father of three and grandfather of seven developed Atrial Fibrillation following a colon re-sectioning procedure he had done after being diagnosed with colon cancer.

Since the A-Fib procedure, Enzwiler said he’s doing well. “I haven’t had any episodes,” he said. “I didn’t know I was in A-Fib until I got really dizzy or I felt really tired.”

Enzwiler said the difference between how he feels now and how he felt before the procedure is “unbelievable.” He no longer has to worry about getting dizzy or overwhelmed with tiredness while on family outings or playing tennis or golf.

Latest technology

Saha said Prairie Heart Institute at St. Elizabeth’s is the first hospital in the southwestern Illinois region to perform treatment of the entire spectrum of arrhythmias and cardiac implantable devices. The lab is outfitted with a low radiation dose BiPlane angio suite which allows for two x-rays to be taken at the same time, a 50-inch multi-input display and other advanced technology systems.

“The technology he’s (Saha) chosen to use guarantees a higher rate of success and fewer rate of complications,” Schneider said. “He kind of goes that extra mile to make sure that everything is being done to make sure the patient is safe.”

Patients undergoing a procedure in the EP lab are intubated and sedated using a special ventilator called a Jet Ventilator. “If you ventilate them (patients) very fast, the heart doesn’t move in the chest,” he said. “That’s a special technology I was trained with that we use here that I don’t think is being used in a 400-to 600-mile radius.”

Saha performed an atrial fibrillation ablation on a patient in the lab Wednesday. In Atrial Fibrillation, the rhythm in the top chamber of the heart is not a “nice, normal rhythm,” he said, instead it’s “disorganized and chaotic.” The irregular rhythm can lead to a stroke, shortness of breath and fatigue.

“In an EP lab, we can take care of heart arrhythmias by putting flexible tubes through the legs all the way up to the heart,” he explained. “We try to find the arrhythmia focus, and we can use special catheters to cauterize or burn the circuits to get ride of them.”

A lot of A-Fib patients go on medications to try to suppress it, according to Saha. “An option we have for many of these patients is putting in a catheter — a curative approach,” he said.

The best type of patients for an A-Fib ablation are those who go in-and-out of A-Fib, Saha said. However, he said they can do patients who are stuck in A-Fib.

“He’s not turning anyone away. We are doing the most complex patients here,” Schneider said. “You don’t usually see those in a community hospital. We are very fortunate to have this available right here, and we are doing it the appropriate way.”

What are the risks?

“Any time there is a procedure that involves moving catheters in the heart there’s a small risk of complications that may arise,” Saha said. “The multiple technologies that we use to prevent those complications from happening include ultrasound catheters watching every heartbeat ... electrical information we see while we are doing our burning or our ablation, and obviously, we are ready to go if anything were to happen.”

Complications can include bruises and bleeding at the groin access site to perforation of the heart, according to Saha.

Saha has performed 80 of these complicated procedures on A-Fib patients, according to Schneider, and 150 patients total. A procedure takes about four hours.

Under the best circumstances, Saha said there’s typically an 80 percent success rate. In the 20 percent of patients that have reoccurring A-Fib following an ablation procedure, it can be manageable with medications. If another procedure is necessary, Saha said it’s usually shorter and increased success rate to between 80 and 90 percent.

“No one has left the room unsuccessful,” Schneider said. “The waiting period is does it reoccur.”

Saha, who is also credentialed at St. John’s Hospital in Springfield, has also performed other types of radio frequency ablations including ventricular tachycardia, premature ventricular conduction, supra-ventricular node and epicardial ablations.

When St. Elizabeth’s replacement hospital opens in O’Fallon in 2017, Schneider said the EP lab and all its equipment will be relocated to the new hospital on Green Mount Road.

Increasing cases of A-Fib

It is estimated that 5 million Americans have A-Fib and that in the next 50 years that number will increase to at least 12 million.

“Atrial fibrillation is a very big public health problem,” Saha said. “There’s a very large predominance of Atrial Fibrillation. The data is all showing its going to become an epidemic.”

Saha treated A-Fib patients as young as 25 years old. “Arrhythmias come in all shapes and sizes and all age groups,” he said. “Atrial fibrillation...is more commonly seen as we get older unfortunately.”

While medication can control A-Fib in many patients, some continue to have symptoms despite treatment with multiple medications. Symptoms can range from shortness of breath, dizziness, extreme fatigue and other symptoms that can affect a patient’s quality of life.

To prevent A-Fib, Saha said it’s important for people to eat healthy and exercise, but genetics also plays a role. People who suffer from hypertension, sleep apnea, diabetes and high cholesterol are at a higher risk, he said.

This story was originally published July 22, 2015 at 4:14 PM with the headline "New lab at St. Elizabeth’s aims to help patients with irregular heartbeats."