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    Stereotaxis for Arrhythmias: Tom Enberg's Story

    Tom EnbergNone of my uncles on my mom's side ever made it to age 60,"says Thomas Enberg. "They all died of heart attacks."

    So in 2000, at age 57, when Enberg first experienced an abnormal heart rhythm, he immediately recalled his genetic background and was understandably alarmed.
    "I was at a family gathering when suddenly my heart went crazy,"recalls Enberg of his first episode. "I thought it was going to jump out of my chest."

    For the next decade, Enberg underwent numerous procedures for heart issues including a triple bypass in 2003 to remove some serious blockages, and a procedure called an atrial flutter ablation in 2008 to correct an irregular rhythm in the right atrium (chamber) of his heart.

    Then in March of 2012, he was diagnosed with atrial fibrillation (AF) – an irregular heartbeat in the left side of his heart.

    By itself, AF is not life-threatening. But left untreated, it can increase the risk of heart failure or stroke.

    The procedure involves inserting thin tubes (catheters) into the patient's blood vessels and advancing them toward the heart. High-frequency electrical impulses are used to isolate and cauterize (ablate) the abnormal tissue that is generating the irregular impulses.

    Alan Schwartz, M.D., a Mills-Peninsula electrophysiologist, performed Enberg's atrial flutter ablation procedure in 2008 as well as his atrial fibrillation ablation in 2012. But the two procedures were performed in two very different ways.

    Conventional procedure

    In the atrial flutter ablation, Dr. Schwartz used the traditional technique, manually pushing a stiff, pointed catheter gently through the heart. "With the conventional procedure, I had to wear heavy lead garments (to protect myself from X-ray radiation) while I stood next to my patient for the entire operation, which could be up to two hours."

    The conventional method can be dangerous, however, if the doctor is working in the very delicate left atrium. Even highly skilled surgeons can accidentally push the catheter into the moving, beating heart at the wrong second, causing a bleeding tear in the fragile atrium wall.

    Amazing new technology

    Dr. Schwartz performed Enberg's AF ablation in the stereotaxis cath lab in the new Mills-Peninsula Medical Center. "It's unusual for a community hospital to have stereotaxis," says Dr. Schwartz. "This type of equipment is usually present only in university hospitals. So we're excited to offer this advanced technology to our patients."

    Using the new stereotaxis system, flexible catheters are gently pulled and manipulated through the heart by magnets, using a computerized robotic device.

    "Using highly sophisticated 3D images and a computer mouse, I can control the entire procedure, including guiding the catheters within one millimeter of accuracy."

    Unlike the rigid, sharp-tipped old catheters, the new stereotaxis catheters are soft and pliable – the texture of wet noodles. "So it's virtually impossible to puncture the inside of the heart and cause bleeding,"he says.

    "Thanks to Dr. Schwartz, I'm running like a racehorse,"says Enberg. Enberg travels the world. "So I have to know that my heart is beating well with no surprises. I plan to return to Africa ... so I'll be in places where you can't call 911."