by TIM CRAIG
Madeline Falardeau knew she had heart problems. The Winter Haven senior could tell when she had an episode coming on – she would start to feel dizzy; her heart would beat slower; she had difficulty breathing. She knew not to panic.
Yet, when those symptoms came on a morning in early May, it was different. “This time I was really feeling it,” she says, “I knew I had to go to the hospital. It was a Tuesday and I called 911.”
Once at Heart of Florida Regional Medical Center, her doctor, Saiyed Mohib called for X-rays and blood tests. The indications were congestive heart failure. He called for medication to help reduce the amount of water around the heart and it was then that he approached a familiar subject: a pacemaker.
The pair had discussed this option before, but Falardeau always said no. “I feel too young and I wasn’t going to put one of those things in me,” she says, “This time, though, was different. I told him that I don’t care, you do what you’ve got to do. I’m taking it.”
It was one of the best decisions Falardeau ever made. Dr. Saiyed came in the following day and said she was scheduled for surgery the following day. And he had more news: she wasn’t getting just any device, she recalls, “he said he was giving me the Cadillac version of the pacemaker.”
The “Cadillac of pacemakers” turns out to be a biventricular pacemaker, which, according to research, not only helps the heart maintain a regular heartbeat, it can also strengthen the heart.
To get the Cadillac of pacemakers, though, certain conditions must be met, according to Dr. Mohib. Tests for congestive heart failure measure the strength of the heart muscle and what is known as the ejection number.
“When a heart beats, it ejects 50 to 60 percent of the blood out at any given time,” says Mohib. “When that number gets below 35 percent, the squeeze function is compromised and a patient needs to start worrying about more things.”
These “more things” include low energy, shortness of breath, or swelling. But, as time goes on, the heart can also begin to exhibit rhythm problems. As Dr. Mohib examined the results of Falardeau’s test, she exhibited all of the conditions: her ejection number was under 35 percent, and her heart exhibited signs of dyssynchrony. A biventricular pacemaker not only keeps the heart pumping, it adds a way for the heart stay in sync with itself.
“When the different parts of the heart go out of synch, the efficiency goes down,” says Dr. Mohib, “it’s like the sides of the heart are not talking to each other. This device fixes that problem.”
To implant the biventricular pacemaker, Dr. Mohib brought in his Heart of Florida colleague Dr. Safi Ahmed, who specializes in cardiac electrophysiology. Dr. Ahmed was trained specifically for this type of surgery and, prior to coming to Central Florida, worked at a teaching hospital in New Jersey, training cardiology fellows. He recently opened the Arrhythmia and Cardiovascular Institute, with offices in Davenport and Zephyrhills.
A biventricular pacemaker, according to Dr. Ahmed, helps the patient by doing two things well. First, as a defibrillator, it recognizes a cardiac arrest within 10 to 15 seconds and provides an electrical impulse to revive the patient. Second, to keep the heart pumping effectively, it recognizes if the left and right sides are out of sync and provides an impulse to get them back into proper rhythm.
“Basically, it performs a timing job on the heart,” says Dr. Ahmed, “and it has shown that it helps patients live longer, stay out of the hospital and have a better quality of life.”
While the device itself performs double duty, implanting the device is not as risky as it seems. Dr. Ahmed says the incision is as small as a matchbox. The device itself is implanted under the muscle and is therefore protected by not just the layer of muscle, but also a layer of fat and skin, making it more secure. There is minimal scarring, with patients reporting the ability to wear a bikini without showing the incision.
“The fears of patients can be irrational for the most part. There is relatively low risk, but we need to take everything in perspective, especially when it comes to quality of life. We should change our mindset as a community. First, we should try to avoid getting sick, but once there, we should let technology do its thing.”
Madeline Falardeau was amazed from the moment the device was implanted. She was discharged less than 24 hours after her surgery. She says that she didn’t feel like anything was inside of her, it was just a little cut. One thing she did feel was healthier.
“It’s beyond everything you can imagine,” she says. “Before, I felt like I was breathing through a straw and the straw was clogged; now I breathe perfectly. I even went dancing with friends on Saturday night – something I haven’t done in 20 years.”