In ‘Heart and Brain’ Burgas brought back to life a patient with dangerous arrhythmia
The parient, Dimitar Dimitrov expresses his gratitude to the doctors from both wards after the complicated operation
“I came back to life”: a multidisciplinary team of electrophysiologists and thoracic surgeons at ‘Heart and Brain’ Burgas helped a patient with life-threatening arrhythmia
Dimitar Dimitrov calls April 2nd “The day I came back to life!”. This is the day the specialists carried out the final stage of treatment for his life-threatening arrhythmia. They surgically sever the nerves that stimulate the heart and cause it to go out of rhythm. The team is led by Dr. Dimo Mitev and Dr. Nedyalko Dragnev.
Up to this point, the patient had experienced the encounter with death almost daily – his heart worked in a chaotic rhythm and only the electrical impulse from the defibrillator implanted in his body saved him. The implantation was carried out by Dr. Mihail Protic, a doctor with serious experience in charge of electrophysiology at the high-tech hospital complex. Without this device, Dimitri would have lost his life in a second.
Dr. Protic: “A patient was admitted to us with dilated cardiomyopathy, severely depressed cardiac function, an implanted cardioverter-defibrillator resynchronization therapy system and multiple recurrent ventricular tachycardias leading to seizures with activation of the implanted defibrillator. In this patient, we performed catheter ablation, which was able to achieve a significant reduction in cardiac arrhythmia episodes but not complete suppression. According to the state-of-the-art treatment recommendations, a surgical intervention, bilateral sympathectomy, is performed in addition to catheter ablation.”
Dr. Mitev: “The last stage of Dimitar’s treatment was in the thoracic surgery department. It took place surgically. In patients with a resynchronizing pacemaker, it is very dangerous to use a monopolar, and in some cases, when close to the heart, a bipolar current. In this case, it was extremely dangerous because of the high frequency of defibrillations required. For maximum patient safety, we used high-energy ultrasound equipment at every stage of the operation. The outcome of the procedure exceeded even our wildest expectations. Compared to the daily “restart” of the heart by the implant prior to surgery, the patient has not had a single ICD defibrillator activation in the last 40 days.”
“Patients indicated for ICD-defibrillator implantation have rhythm-conduction disorders and are at risk for abnormal heart rhythms. They have had a heart attack, have a weak heart, or have inherited heart disease,” explains Dr. Protich. “The ICD is as big as the face of a smartwatch. Once implanted under the skin, usually on the left side of the chest, it detects and regulates abnormal, life-threatening rhythm-conduction disturbances and can prevent fainting, even sudden death.”
“If you have an abnormal heart rhythm that the device determines to be dangerous based on established algorithms, it will respond to return the heart rhythm to normal. This may involve receiving an electrical impulse, as in CPR,” the electrophysiology specialist explained. “Rather than being applied externally, the pulse is delivered from the implant into the body immediately. This helps save lives.”
Many of the patients of , Heart and Brain’ Burgas suffer from cardiovascular diseases. The hospital employs some of the best electrophysiologists on the Balkan Peninsula, such as Dr. Mirazciiski, Dr. Protic, cardiologist Dr. Dimov and cardiologist-specialist Dr. Anastasov. This is the only electrophysiology center in Southeastern Bulgaria and provides access to the most advanced treatment of rhythm-conduction disorders. “Instead of patients having to travel periodically to Sofia, ‘Heart and Brain’ provides all care related to the implanted devices here in Burgas. Long-term follow-up is also important because many patients need device-related care for years. We ensure continuity of care: we know the patient before implantation and communicate closely with them and their treating cardiologists afterwards.”
Some of these devices don’t just prolong life expectancy, they also improve its quality. This procedure is minimally invasive and low-risk. In cases such as Dimitri’s, close collaboration between multiple specialists is extremely effective and has the added benefit of improving patients’ quality of life. Video-assisted thoracoscopic sympathectomy has also recently been performed at the hospital to improve the overall treatment outcome for complex and life-threatening arrhythmias.
