Mending Broken Hearts
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Danell Bonam was enjoying a fun afternoon, running and jumping with her friends when suddenly, her heart started racing.
"We had noticed a rapid heart beat before, but we were always able to explain it away. She was running or she was playing hard," says LaKeisha Bonam, Danell's mother. "This time, even after resting, her heart wouldn't slow down."
Hours later, Danell's heart was still pounding at 250 beats per minute, about two and a-half times faster than the normal heart rate for a child her age.
Her parents rushed her to the Children's Hospital & Medical Center Emergency Department. Physicians determined Danell was suffering from supraventricular tachycardia (SVT), a rhythm disorder originating in the upper chambers of the heart.
"While there are many causes for SVT, we found Danell's issue was related to a condition she was born with called Wolff-Parkinson-White Syndrome," explains John Kugler, MD, director of cardiology at Children's Hospital & Medical Center and chief of the Joint Division of Pediatric Cardiology.
In a normal heart, one pathway allows an electrical signal to move between the upper and lower chambers. When this signal reaches the heart muscle of the lower chamber, blood is pumped out of the heart and the heart beat is completed. In patients with Wolff-Parkinson-White syndrome (WPW), the extra pathway provides the potential for the electrical signal to beat through both the normal and the extra pathways creating an abnormal heart rhythm and very rapid beating known as tachycardia.
Danell required medication to control the rapid beating. Without it, the SVT would return. An effort to decrease her dosage was unsuccessful and after awhile, even the medicine couldn't stop the episodes.
"We reached a point when, despite medication, she would have 'breakthroughs,' and the fast heart beat would return," remembers LaKeisha.
In February 2009, Dr. Kugler and the pediatric cardiologists at Children's recommended a treatment that could permanently stop Danell's SVT and cure the underlying cause.
The procedure was performed in Children's hybrid pediatric heart catheterization lab. Dr. Kugler and the cath lab team carefully inserted small catheters in large veins in Danell's upper legs, as well as a catheter in her esophagus. The team induced a fast heart rhythm in order to confirm Wolff-Parkinson-White syndrome was causing her arrhythmia. Once that was done, they mapped out the extra pathway and performed an ablation, using radiofrequency energy to create a small burn and eliminate the unwanted pathway that was causing the rapid heart beat.
"The procedure was successful. Danell no longer has WPW, and there's no chance of having the extra fast heart rate return. We consider her cured. She can go and play without any restrictions whatsoever," says Dr. Kugler.
"Danell's recovery went well. She didn't even have to spend the night in the hospital the day of her procedure," says LaKeisha. "Our doctors were awesome, and they did a great job answering all of our questions."
Under the leadership of Dr. Kugler and pediatric cardiologist and electrophysiologist, Christopher Erickson, MD, Children's expanded its cardiology services to include electrophysiology capabilities, including catheter ablation, in September 2008.
"WPW is just one of the many abnormal tachycardia conditions in children, adolescents and young adults that we are able to potentially cure with this special technique," says Dr. Erickson. "We're excited for the possibilities that exist and look forward to continued success."
"This is a significant step for the pediatric cardiology program at Children's. Not only can serious arrhythmias disrupt every day life for children and their families, they can become quite dangerous. Our ability to provide such a specialized and advanced form of treatment in a setting designed to meet the needs of pediatric patients is important," adds Dr. Kugler.