Collaborative Treatment Helps Pete Get Moving After AFib

If you stacked all of the steps that Pete Fenboque has climbed in and out of school buses, you’d reach astonishing heights. After all, he’s spent the last 27 years driving a bus and training new drivers as well. But when climbing only a couple steps at a time became a chore that left him winded and fatigued, Pete could tell something wasn’t right and he knew from past experience to pay attention to symptoms.

Pete’s first experience with the TriHealth Heart Institute came in 2007 when he was rushed to the emergency department at TriHealth’s Bethesda North Hospital by emergency medical responders from the firehouse where he was a firefighter at the time. He had been experiencing severe chest pains which radiated into both arms and he eventually passed out and had to be resuscitated. 

The team at Bethesda North determined that Pete had suffered a heart attack and Stephen Lewis, MD, a cardiologist and system chief at the TriHealth Heart Institute performed an emergency angioplasty and inserted a stent into his coronary artery to restore blood supply to the heart.

“Dr. Lewis saved my life that day,” Pete says. “I was very lucky and I know it. Everybody there took good care of me.”

Pete was on the road to recovery following his heart attack and was in good health until late 2014 when he began experiencing shortness of breath and extreme fatigue. While not as sudden or alarming, Pete’s symptoms this time were enough to consult with Gaurang Gandhi, MD, an electrophysiologist with the TriHealth Heart Institute and director of electrophysiology and cardiology at Bethesda North Hospital. Pete was diagnosed with atrial fibrillation (AFib), an abnormal heart rhythm in which the upper chambers of the heart beat irregularly instead of beating effectively to move blood into the bottom chambers of the heart.

“I had a lot of fatigue and no strength,” Pete says. “Everything was an effort to do because I was in AFib all the time. Don’t let anybody tell you it’s a walk in the park.”

In addition to shortness of breath and fatigue, symptoms of AFib include heart palpitations, weakness, dizziness and chest pain. While it is not directly life-threatening, it is important to pay attention to it because it can lead to other heart-related complications, such as congestive heart failure, according to Eric Okum, MD, a cardiothoracic surgeon with the TriHealth Heart Institute.

A Team Effort From the Local Leader

For cases such as Pete’s that require treatment more extensive than medication such as blood thinners, TriHealth offers a hybrid mini maze treatment, a newer strategy that involves collaboration between a surgeon and an electrophysiologist. TriHealth is the only provider performing this hybrid treatment in Cincinnati and one of only about 50 nationwide.

The first part of Pete’s treatment was a minimally invasive maze procedure (mini maze) performed early in 2015 by Dr. Okum at Bethesda North. A mini maze uses heat to create a pattern of scarring along the left atrium to create a disturbance that corrects the irregular heartbeat. Because the procedure is performed thoracoscopically and is minimally invasive, there is less pain, less risk of infection and easier recovery than through open heart surgery. It involves eight minor incisions with four on each side and usually requires a hospital stay of only three to four days.

“This procedure makes a patient feel better, even those who are asymptomatic,” Dr. Okum says. “No matter how they felt when we started, when they get out they feel better.”

This was certainly the case for Pete. “I felt amazingly different,” he says about his own immediate recovery time. “I woke up sore, but I actually felt good for the first time in a while”

The second part of the hybrid treatment is catheter ablation during which catheters are inserted to use heating or freezing energy to block conduction of abnormal electrical impulses and in many cases prevent the recurrence of AFib. Ablation is generally performed three months after the mini maze procedure to ensure it continues to have the desired effect.

Pete’s ablation also was performed at Bethesda North by Dr. Gandhi, who credits TriHealth’s team approach with providing a success rate of greater than 85 percent for patients like Pete.

“We are very fortunate at TriHealth to have a team of surgeons and electrophysiologists working together to offer a range of procedures and treatment options,” he says. “We all provide our input on all of the options and benefits and work together with the patient to determine the best plan for them.”

Getting More Out of Life After AFib

For Pete, that success means once again climbing into a bus without effort and resuming activities he enjoys such as hiking and riding a bike. His heart rate is monitored through an implanted chip and since his treatment in 2015, he has had no occurrences of AFib.

“It was just a joy to be able to do these things again,” he says. “It felt great to not be winded.”

Pete’s story and immediate improvement are an example as to why it’s important to pay attention to symptoms affiliated with AFib, according to Dr. Gandhi.