Health Update: Ventricular Tachycardia Ablation

SUP

As 2014 comes to a close I want to reflect on what the year has meant to me and give you a further health update.

I started the year on a high note, with lots of high demand research to carry out on scaling up high growth companies, corporate innovation and tracking various trends in emerging technologies. I was rearing to go and ready for a solid calendar of international travel when bam, out of the blue, I hit the ground. I hit it literally and I hit it hard.

I’d suffered a major sudden cardiac arrest, or what is more dramatically known as sudden cardiac death because only 5% of people who have such an attack survive. I was very fortunate to make it through this incident and a subsequent mini stroke. You can read the full narrative of my experience here.

After a few weeks in various intensive care units I left the hospital in March and began a regime of various medications. These medications are designed to firstly keep my blood thin enough to prevent clots and hence reduce the likelihood of another stroke and secondly to temper the excitement of my heart and reduce the number of incidences of ventricular tachycardia I was having. This second medication is called a beta blocker. I was told then that ideally the medication will be sufficient to keep my heart in check, but if not we would need to explore a further operation. At the time I remember wincing, as the thought of another bout in hospital was very hard to contemplate.

Over the ensuing months I tried to return as much as possible to a normal regime of work, exercise and spending time with family. It felt to me like there had been minimal VT activity. However, in mid May my doctors interrogated my device and at that point I’d had 62 episodes of VT that needed ICD pacing. This was a bit of a surprise to me.

My doctors wanted me close so they could monitor me and I was grounded from any air travel. I was able to write, run a few workshops and events and conduct numerous calls with clients all over the world. The distance I was walking started to increase as my strength grew and I was able to increase the frequency of time spend on the water, stand up paddling.

But as June rolled around things began to change. I kept a diary of increasingly frequent incidents at the time. The biggest impact was having to leave a school dinner/dance evening literally as we arrived. I’d begun to feel lightheaded and my ICD kicked in to pace my heart back into rhythm. I also went to hospital emergency on one occasion when I had a continuous run of VTs for a few hours.

I’d started out on a relatively low dosage of the beta blocker with the strategy of exploring the optimal range. At the end of July my medication level was raised for a second time. This was to counter the increased level of activity I was experiencing.

Mid-August I had a second device interrogation. I remember going into the session feeling really upbeat. I fully expected to have my travel restrictions lifted. The results floored me and dashed my expectations of getting on an aeroplane any time soon. Over a 3 month period I’d had a staggering 1,625 VT incidences, of which 99 had needed the ICD to intervene and provide pacing therapy. Not only was the level increasing, but this was well above the norm. The possibility of another operation was again raised at this point. While I wasn’t too keen on the thought I was starting to think this may be a good idea. The VTs were leaving me more and more exhausted.

At this point I pared back my exercise regime to mainly only doing yoga and the occasional walk. Yoga proved to be a great help though, both for stretching out my muscles and for calming the mind and giving me increased focus.

As the months passed I began to have increasing VT runs an hour or so before dinner time. I love cooking and it became almost impossible to make dinner without having to have the rest of the family take over.

My beta blocker dosage was again increased and I was now on the highest dosage. I felt completely drained. Between the VTs and the medication I was struggling to even walk from one side of the house to the other. I had to pull out of delivering a number of talks and workshops at a large company event.

With the end of the year approaching fast, my doctors kicked into action and I was referred to a specialist in VT ablations. I was fast tracked for an operation in a fortnight – the first week of December.

The operation would be performed via catheters which would firstly map out the VT circuits (the electrical activity) and then once isolated these would be ablated (zapped) at source. It’s a tricky operation complicated by the fact that I am on blood thinners and prone to having strokes.

Ideally, the doctors want to see VT activity taking place while they are mapping so they can more accurately determine where the circuits are eventuating from. This means that the patient must come off their medication and undergo VT events.

Given the number of events I was having it was prudently decided that I go off my medication in hospital rather than at home. I was totally off all medication for 36 hours and this was one of the hardest things I had to endure this year, if not ever. I was in almost constant VT that whole time and I estimate, conservatively, that during those 36 hours I had over 2,000 ICD-treatable VT episodes. Just one of them makes you feel like you have run a marathon. Many times I thought I’d pass out as attacks can reduce blood flow to the brain, but I didn’t lose consciousness once. Going to the bathroom, having a shower, things we normally take for granted, felt like massive challenges.

Eventually the morning of the operation arrived. I could not walk by this point and was wheeled into the operating theatre on my bed. I won’t go into the details, but it was a marathon 4.5 hour operation. The good news is that they were able to find where the VTs were originating on my right ventricle (the easier one to get to via catheter) and they well and truly ablated these misfirings. They did note that there is some activity on the left ventricle but this would have taken another 2 hours to map and the window of opportunity closed.

I’ve been home for a day now and I’m recuperating well. I haven’t had any VT activity to cause concern. If the level of activity remains low, then I hope to reduce my beta blockers to a lower level and get back into the swing of things in 2015 in a big way. Yes, there is always the possibility I’ll need to go for another procedure to tackle my left ventricle, but this may not eventuate.

In the meantime, doctors are making strides to be able to conduct such a procedure using much less invasive techniques that have extremely high accuracy. I certainly intend to keep a very close eye on these advances.

To all my friends, family, work colleagues and the doctors and hospital staff who have looked after me I thank you so so much for your support and I wish you only the best for 2015.

[The photo was shot on a paddling session with my son Tyler, on the creek at Bobbin Head, Sydney]

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