Long-distance swimming isn't just a hobby for Dr. Tom Syzek. It's a passion. But when his heart started showing signs of atrial fibrillation (AFib ), he knew it might put his lifestyle at risk.
While most AFib increases heart rate, his was slowing down. "I found it was a kind of atrial fibrillation that occurs in distance athletes," says Dr. Syzek, who practiced as an emergency room physician in Cincinnati for 26 years.
Atrial fibrillation happens when the top chamber of the heart beats out of sync with the lower chamber. Over time this can weaken the heart, but even early symptoms like fatigue and shortness of breath were unacceptable for Dr. Syzek.
"In 2011 I won the U.S. Masters national long-distance open water championship in my age group, so it's not like I'm a cardiac cripple," Dr. Syzek says. "I won it again in 2015 while I was having the arrhythmia on and off."
A decade earlier, Dr. Syzek had met Dr. Sai Hanumanthu, a 'TriHealth cardiologist who treated Dr. Syzek's mother-in-law and later his wife. Dr. Hanumanthu's compassion and willingness to listen made a lasting impression, especially in Dr. Syzek's case. "He cared for her as if she were his own wife or sister."
Dr. Hanumanthu also shared a passion for swimming, and their acquaintance grew when they discovered they swam at the same pool.
"Both of us love swimming, though Tom is far better than I am," Dr. Hanumanthu says. "He would swim with the swim team, a bunch of 12- to 18- year-old kids. At that time he was nearly 60, absolutely doing phenomenally. Then one day he said, 'Sai, I'm pretty sure I'm going into atrial fibrillation. I checked my pulse, what do you think we should do?' That's how the conversation started."
The usual blood thinners and other medications common for patients of Dr. Syzek's age weren't likely to keep him swimming. ''We tried medical therapy, and being an athlete he was having some side effects with the medicine," Dr. Hanumanthu says. "So then we started talking further, he did some of his own research, and then I put him in touch with our electrophysiologist, (Dr.) Marshall Winner."
As a long distance runner, Dr. Winner could appreciate Dr. Syzek's desire to maintain peak performance. "It helps for him as an athlete to understand where I'm coming from," Dr. Syzek says. "He didn't immediately impose a cookie-cutter kind of treatment on me.''
One of the options they discussed was a procedure called an ablation. "Essentially we make small burns inside the heart to eliminate the short circuits that are causing the abnormal heart rhythms,'' Dr. Winner says. "If the medicine is not working then generally the next step is an ablation."
Dr. Syzek needed some time to think it over and appreciated the lack of pressure. "You've really got to trust somebody to allow them to burn 70 little spots near your heart with four gigantic catheters under general anesthesia, and surrender control like that when I've had a 34-year career in medicine.''
Moving to Colorado in December 2015, Dr. Syzek found the combination of altitude and AFib to be extremely limiting. He made up his mind to re turn to Cincinnati for the procedure. "I had so much respect and trust in that duo that I flew back for my ablation in February of 2016.''
"For someone like Tom, this procedure was a no-brainer," Dr. Hanumanthu says. "If it were me I would have done this as well.''
"It's always interesting - and a little bit more stressful -when it's a fellow physician," Dr. Winner says. But Dr. Syzek was able to leave the hospital the next day and the results have been inspiring. "Since that time the AFib has been under good control. He's back to swimming and not having any trouble.''
"I train at high altitude and have climbed 14,000-foot mountains," Dr. Syzek says. "I've had all physical limitations on my activity erased. I don't think about my heartbeat anymore.
"It was heartening as a fellow physician, and I've run into thousands of them, to see two guys so dedicated to helping other people. I don't think I got special treatment. I think they did for me what they would do for any of their patients."