Just before he is wheeled into surgery, Gary Lovell jokingly asks a nurse if she has had her coffee and then kisses his girlfriend, Brenda Lahtinen, telling her, "I love you, Sweetie."

 

Only 50 years old, Lovell, a Perryville native, suffers from an atrial fibrillation that can reduce his left atrium to a 400-beat-per-minute quiver. When that happens, his chest flutters and he feels lightheaded, and worse, he can suffer a stroke, as he did the previous November.

 

The beta blockers he now takes regulate his heart at a static 60 beats per minute no matter what he is doing or how badly his body needs the blood to flow.

 

"I'm not able to work," he said. "I can work three or four hours and go lay down and take a nap, and I wake up three or four hours later. I mean, it just totally just saps me."

 

Today, he'll undergo an atrial fibrillation ablation at St. Vincent Infirmary Medical Center using the CARTO-3 Navigation System from Biosense Webster, the only such system in Arkansas.

 

The technology will enable Raj Chakka, MD, a cardiologist and electrophysiologist, to see inside Lovell's heart without cutting him open. Within a few days, Lovell should be able to resume a normal life.

 

Prior to surgery, a CT scan creates a picture of Lovell's heart. Then during surgery, five Navistar Thermocool irrigated ablation catheters, also from Biosence Webster, are inserted into the groin and threaded to the heart. Chakka maneuvers the catheters around the chamber's walls, enabling him electronically to map the boundaries. Images from the CT scan and the catheters' maps are then merged to produce a more accurate, three-dimensional sense of the chamber's depth than previous systems have allowed. One catheter has an ultrasound tip and is threaded into the right atrium, giving Chakka a third pair of eyes.

 

According to Chakka, Lovell's condition is caused by muscle fibers that inadvertently are created along pulmonary blood vessels when the heart forms, a process he compares to plant splattering. This probably happens to everybody but doesn't cause a problem in most. For patients like Lovell, however, the muscle bundles begin firing and cause the heart to go into fibrillation.

 

The procedure gives surgeons a better idea of how many blood vessels are involved, what sizes they are, and where they are located. The use of numerous catheters shortens the procedure, which reduces the possibility of complications.

 

The ablation process uses a radio frequency to cauterize the defective muscle fibers and allow the chambers to resynchronize. "We're going to zap those muscle fibers and electrically isolate these blood vessels from the heart, so whatever firing still happens but stays within the blood vessel and (doesn't) come into the heart," Chakka said. "It doesn't do much damage inside the blood vessel."

 

Chakka said the new system is a big improvement over the previous, much more limited version of the software, which enabled doctors to use the catheters to touch only one point on the chamber walls at a time.

 

The condition is common in the elderly and affects 5.6 million Americans, but it also strikes younger adults as well. Some patients suffer every day a few minutes, some for several hours a week, and some once a month for a couple of days at a time. The stroke risk greatly increases after more than 24 hours. Many don't realize they have the condition until they are in the emergency room suffering from a stroke.

 

Now a real estate appraiser, Lovell retired from the military in 2000 having no such symptoms. There is no history of heart disease in his family.

 

After the ablation procedure, patients like him can go home the next day and, after some limitations in the amount they can lift for a few days, can return to living a normal life. The day before Lovell's surgery, Chakka visited three patients who had undergone the procedure in the previous six weeks. All were doing well.