Good Heart, Second Chance: Atrial Fibrillation AFIB

Posted On 10/31/2011 19:19:39 by Advanced-Medical
Good Heart, Second Chance
by Gil Case, PhD, CEO 
Ever so often we all get a message.  My message was clear, you have persistent atrial fibrillation (AFIB).  Taking Coumadin for 10 months was a real drag and experiencing the side-effects of this old-fashioned drug:  significant hair loss and a decrease in libido was terrible.    
Psychologically, this was the worst 10 months of my life.  Not only did I have to cease my sports activities and overall activity, but I also realized that the blood clots potentially formed in AFIB could result in a very serious brain stoke and possibly death. 

OK, I got the message, so I took action, in fact many actions and as soon as possible.  First, was the undeniable proof of my missing P wave on my EEG.  This is the number one indicator for AFIB. Second, I sought out a local electrocardiologist who gave me two cardioversions.  Each one lasted about two days, then the AFIB came back.  A cardioversion is when 160-220 joules of electric shock (under sedation) is applied to your heart to force it back into rhythm,  Now my smiling electrocardiologist is rubbing his hands in a circular manner and says to me “you need an Ablation” and our success rates with for ablations for your type of persistent AFIB is about 70%.  

This is when I consulted the Internet and friends.  I had a friend who was cured of AFIB in one visit to the University of Alabama (UAB) hospital and a noted UAB specialist did his ablation.  I was so impressed that I subsequently did the procedure with this same specialist.  As it works out, UAB is one of the top AFIB places in the United States and that specialist does over 300 of these procedures every year.  


The actual cost to my insurance carrier for the ablation was around $60,000 for the 1-day in-&-out procedure that normally lasts about 2-3 hours.  


The procedure is rather simple,  an electrical line is run from your groin area up to your heart with use of imaging to determine the areas of irregular electrical activity and then the specialist “spot” cauterizes those areas.


Here's the missing information that my local heart electrocardiologist and the super-duper one at UAB did not tell me.  The reason they didn't tell me, is simply because they didn't know. In fact, both these doctors  are specialists in their small world and both receive giant paychecks directly related to the number of procedures they perform.  Enough complaining about why doctors can be so dumb yet convince you that they are so smart,  here's what I found out the hard way.  

1) Persistent Afib is much more difficult to cure than sporadic Afib.  That is, if your Afib occurs one to five times a year, you have sporadic Afib and you are a great candidate for the ablation procedure. However, if you have persistent Afib, that is, it is occurring 24/7 then you have a very serious condition.  Come to find out, the published success of ablation for persistent Afib is 19% (you have to really dig to find this number) and if you have three of these $60,000 procedures you chances rise to 50%.

2) There is another procedure that offers 95% cure rate, but it is a very serious invasive heart surgery, called the Cox Maze procedure, in which the chest is opened to see and properly fix the problem.  The cost of this operation is also about $60,000.  Length of surgery is normally 4 hours.   
3) After my ablation at UAB, it only took about 10 days until my Afib came back, thus that procedure was a failure. When I called the UAB specialist, he was not surprised and recommended another ablation to increase my percentage of success.  Well, call me stupid if you wish, but “No way Jose”.  There's got to be a better way.

4) After much Internet research, I found a Dr. John Sirak at the Univ of Ohio State Hospital who performs a surgical procedure call the Five Box Thoracic Maze (  It's the same basic surgery as the Cox Maze but the chest area is not opened, instead 8 punctures are made to minimize infections and complications from opening the chest.  The success rate for this new form of surgery is 95%+.  Further the Cox Maze surgery has about a 1% death rate and about a 1% infection rate.  This means of the 5% unsuccessful, you could be dead or you could have a serious and debilitating infection.    

5) I was about the 312th surgery for Dr. Sirak.  Of those whom he preformed the Five Box Thoracic Maze, there were zero deaths and zero infections.  In addition, the Ross Heart Hospital at Ohio State University is a magnet hospital and is rated #20 of the 100 top hospitals in the United States.
6) Antiarrhythmic drugs are necessary. See  To have me properly recover over a three month period from the Thoracic Maze surgery, Dr. Sirak prescribed Sotalol 80 mg twice daily to keep my pulse rate in check.

7) I am now cured of persistent Afib, but the operation took 6 hours and it is not to be dismissed as minor surgery.  It indeed is major surgery and should not be taken lightly, even with the extraordinary success rates. 


The greatest feeling was when I woke up from surgery, feeling like God had given my a second chance on life.  My surgery was in July and now it is October, oh how wonderful it is to “really” be alive.  My epiphany is simple: Good hearts can be repaired and a person's determination to find the best solution is a key part of realizing “your quality of life is in yours hands.” 


My wife suffered as much as I did and saved my butt more than once both physically and psychologically.  I thank Dr. Louis Bolen, Medical Director for Advanced Medical Health Clinic for his wise suggestions in my emergency at the early part of my recovery.  I give my deepest thanks and love to my wife Napawan (PhD and RN) who saw me through the ordeal, the procedures, the surgery and my erratic recovery.  Now my message is clear, “you have a second chance, so don't blow it.”  


Gil Case runs Advanced Medical Health Clinic located at 3015 Powell Rd here in Tallahassee.


Advanced Medical Health Clinic offers a unique, rehabilitation methodology to accurately exercise spinal disks and rejuvenate their function.


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