Profiles | Gary Hanshew

Fifty-eight-year-old Gary Hanshew, who spent 40 years working in the auto body repair service, describes his heart condition as feeling like he had a large car sitting on top of his chest.

"My heart would beat so fast that I wasn't getting enough blood or oxygen to my brain, so I'd feel very lightheaded, dizzy and tired," says Hanshew. "My heart was literally beating out of my chest; it felt like I could have a heart attack at any minute. It was a horrible way to live."

Hanshew suffers from severe atrial fibrillation, a type of arrhythmia that causes an irregular heartbeat. With atrial fibrillation, many parts of the atria, the heart's two upper chambers, emit uncoordinated electrical signals. The electrical impulses cause irregular, erratic and unusually fast heartbeats. During periods of atrial fibrillation, also known as "AFib," Hanshew's heartbeat would accelerate to 180 beats per minute. Normally, an adult's heart beats between 60 to 100 times per minute.

Hanshew experienced his first bout of atrial fibrillation in 1981, though his cardiologist thought he just had a "cold" in his heart and there wasn't much he could do. It wasn't until 1987 when Hanshew was finally diagnosed and started taking medications for his condition. But even after trying very high doses of every available drug to help slow down his heart, nothing worked.

Hanshew's erratic heart often brought him to the emergency room, where he had 11 external cardioversions to "reboot" his heart. By delivering high-energy shocks of 50 to 300 joules through defibrillator pads attached to the chest, external cardioversion converts an irregular hearbeat back to a normal rhythm.

Hanshew also had a pacemaker implanted to help regulate his heartbeat. He underwent seven cardiac catheterization procedures during which stents, or metal tubes were inserted into blocked blood vessels to restore normal blood flow. And after years of taking high doses of powerful anti-arrhythmia drugs, Hanshew suffered from severe side effects that almost killed him, resulting in a thyroidectomy, the complete removal of his thyroid.

Still, nothing seemed to stabilize Hanshew's heart. For the last three years, he suffered from periods of atrial fibrillation almost six days out of each week, which completely disabled and immobilized him. He was forced to retire from his career in the auto body repair service and was restricted from having any kind of normal life.

"I couldn't do anything, except spend all day sitting in a chair and watching T.V.," says Hanshew, who resides in Hidden Valley Lake, Calif. "My wife and I missed out on a lot of things—vacations, get-togethers. We couldn't commit to anything, not even something as simple as a dinner party, because I just never knew when I was going to go into AFib."

Desperate for a solution, Hanshew underwent radiofrequency catheter ablation at a medical center in Santa Rosa, Calif. in 2004. A technique developed at UCSF in the 1980s, radiofrequency catheter ablation destroys or disrupts parts of the electrical pathways causing a heart's arrhythmias, providing potential relief for people like Hanshew, whose condition does not respond to medication.

Catheter ablation involves threading a tiny metal-tipped wire catheter through a vein or artery in the leg and into the heart. Fluoroscopy, which uses x-rays to allow cardiologists to view on a monitor the catheter moving through the vessel, provides a road map. Other catheters, usually inserted through the neck, contain electrical sensors to help find the area causing the short-circuits. The metal-tipped catheter is then manually maneuvered to each problem site and radiofrequency waves—the same energy used for radio and television transmission—gently burn or cauterize away the culprit tissue.

While studies have shown that catheter ablation greatly improves the majority of patients' health and quality of life, and also eliminates their need for medications, Hanshew actually worsened after his procedure and spent three weeks in bed recovering. He credits this to a lack of expertise, involving a lot of "guesswork," and not having the best facilities and equipment.

Hanshew almost lost hope, but then he learned about Jeffrey Olgin, chief of the UCSF Cardiac Electrophysiology and Arrhythmia Service, who is the only doctor in California to perform a new kind of radiofrequency catheter ablation using Stereotaxis Niobe Magnetic Navigation System.

Olgin calls the magnetic navigation system the future of catheter ablation for the treatment of abnormal heart beats. Compared to traditional interventional cardiac procedures in which doctors manually navigate instruments, such as catheters and guide wires, the magnetic navigation system is computer-controlled and uses magnets to direct instruments through veins into the heart. Doctors digitally control movement of the instruments from a control room outside the operating suite using monitors and point-and-click navigation tools and other instruments.

"The computer navigation makes the procedure more precise and safer. Because of the precise control of catheter movement, the procedure can be done with fewer ablations, since they are more targeted," says Olgin. "In addition, because of the precise localization and navigation, both the patient and the operators are likely exposed to less x-ray than with standard procedures."

It's been over eight weeks since Hanshew's magnetic navigation catheter ablation procedure, and he says he's never felt better. He's making up for lost time: golfing and putting an addition on his house. And just as importantly, he now only takes a very low dose of one medication, which he hopes to eliminate completely after recovery.

"After my first ablation, I was in bed for three weeks," remembers Hanshew. "Five days after the second procedure, I was putting a room addition on my house and feeling great. Before, I could barely walk up the stairs."

Although Hanshew's heart beat perfectly for the first eleven days following surgery, he has experienced some short periods of atrial fibrillation since then. Though Olgin says this is common in the first month after the procedure. "While Mr. Hanshew was in almost constant AFib before the procedure, now even during the initial month after the procedure when episodes of AFib are common, he has only had a few very brief ones," remarks Olgin.