Dr. Melvin Scheinman: 40th Anniversary of Catheter Ablation | Hacker News Reader

Dr. Melvin Scheinman: 40th Anniversary of Catheter Ablation

ucsfhealthcardiology.ucsf.edu

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Wolf-Parkinson-White Syndrome, yup, that's me. It killed a college ball player about twenty years ago, killed a high school player just a few years ago:

https://www.nbcchicago.com/news/local/community-aims-raise-a...

I was about 40 years old, and would have tachycardia under a very specific set of circumstances. As in, 30 minutes after exercise, heart rate was still at 140bpm. One stress test later, it was off to get that ablation.

My wife calls it "heart surgery", and I guess technically it is. It's about as easy a "surgery" as you're going to get: lie on a table, get the catheter, half hour later you're done. Stay overnight to make sure you don't bleed out from the catheter site, back home like nothing happened.

If it is suggested to you to get this done, do it, it is super-easy as far as invasive procedures go, and it could save your life. 20 years post-surgery, and I still run ultramarathon trail races, and haven't had a problem since.

I walked out after 11 hours from walking in. It's amazing that you can do it after an instrument piercing through a wall in your heart and freezing some nerves on the other side.

It killed a kid in my sports class growing up as well. Dropped like a stone, cardiac arrest, couldn't be resuscitated. After that they had a 'heart health' mobile ekg come to the school once a year for people who wanted a check up which I thought was a great idea. They actually diagnosed a few people, I think at least two others with WPW but also a more common condition where the wall of the heart thickens which can also be dangerous during exercise.

Happened to a 38 year old bike racer in the Seattle area years ago (https://recycledcyclesracing.wordpress.com/2009/04/13/brad-l...). I didn't mention him above because it was "cardiac arrest", though I always suspected it was undiagnosed WPW. We're not talking some out-of-shape person thinking they'll run a marathon on no training. No, bike racing is unbelievably hard if you don't want to get dropped and pulled from the race after ten minutes. And Brad was good at it.

So an in-shape athlete in a hard sport at the age of 38 just drops dead mid-race from cardiac arrest? Yeah, I have theories (which, not being a cardiologist, are probably wrong).

The only realistic way to get someone back from ventricular fibrillation is cardioversion.

That's why automatic external defibrillators are in so many public spaces these days. If someone drops in your presence, you find that thing and get the pads on them ASAP. It won't shock if not indicated; it will tell you to resume CPR.

A former high school classmate of mine, who had played football with me from fifth grade on, dropped dead walking around in a bookstore at age 23. Almost certainly WPW.

I had the same surgery and would make the same recommendation. Shockingly safe, very high success rate, quick in & out, and easy recovery. A whole lot better than playing tachycardia whack-a-mole for the rest of your life, and those incidents get increasingly dangerous the older you get.

I’ll say I had a good chuckle a couple months later when I went in to have a wisdom tooth removed - the heart surgery felt like futuristic wizard science, the tooth removal felt like a burly man with pliers yanking at my bones.

Shockingly safe

I see what you did there.

It's funny. As a SW dev working on medical devices, I've done at least two catheter ablation machines that I can think of, but I never knew the specifics of exactly what problem it solves. I mean, I obviously know in detail what the device is doing, just not the why.

And it's specific to just that type of device: anything else I've worked on that I can remember ATM, I know what they are used for.

Whoa hold on. I’ve been diagnosed with WPW and my doctor told me there was nothing to worry about (10-12 years ago).

Now I’m flipping my shit a bit, I’ve never heard any mention of this disorder outside of my discussion with the doctor until this very moment.

My symptoms include an occasional fast heart beat out of nowhere (lasts maybe 20-30 seconds), but that’s about it.

What are the circumstances in which the surgery is recommended?

Hopefully you'll see this late reply. I can't give you medical advice, especially for a condition that causes people to literally drop dead. Get a referral to a cardiologist, go do a stress test. No one here can answer this for you on HN, not even a cardiologist. Like a software bug, some can be fixed over the phone and some need a debugger strapped to them. Go see what the EKG debugger says about your heart.

This procedure changed my life. I had two radio frequency ablations in Calgary in the mid 2000s when I was 16 to cure PSVT. They did an electrophysiology study during the first surgery to determine it was dual AV node syndrome, which was one of the best case scenarios. If I had been born a few decades earlier this would have required open heart surgery. The crazy thing about this surgery was that I only had to lie flat for a few days and rest for a week before going back to playing football. No scars, no side-effects.

An interesting side note is that I was awake and high on valium for both surgeries. I remember them inducing the tachycardia with adrenalin and some stimulation during the first surgery and saying "yup there it is" out loud.

Had this done too to cure PVCs - a irregular heartbeat that wouldn't have killed me, but it did lead to an enlarged heart and low energy.

I remember feeling great during the procedure thanks to whatever meds they gave me. I could watch them on a screen threading the wire in through my femoral artery all the way up into the inside of my heart. Then I felt the exact moment I was cured. The irregularity I'd known my whole life just changed rhythm. Then they injected some stuff to stress test the heart at high and low speeds. 24 hours later I was back home.

Thank you for telling your story. It is encouraging. I’m a candidate for the same surgery because of a high PVC burden, but I’ve been resisting doing it because of the risk of death and other life-altering complications.

Hey, I had this done!

As far as surgeries go, this one is easy as hell on your body even if it's performed on your God damn heart! Genuinely life changing and haven't had a real issue in the decade since (occasional flutters are annoying, but expected). Sure as hell beats taking daily meds and an annual-ish episode which results in you getting pumped full of adenosine.

> He spent the next three years pursuing this vision.

I had the chance to try this procedure out when I was 20, and it saved my life. Without it there is a high chance I would be dead. And it is because he had an idea that he pursued.

It is fascinating what modern medicine is capable of.

Oh my, seems to beat a lot of the alternatives.

https://en.wikipedia.org/wiki/Catheter_ablation

Considering that the alternative is "crack open your rib cage, open up your heart, poke around a bit and hope we get it right", yeah, an hour lying on a table while the cardiologist plays your choice of music on the speakers is a nice option.

UCSF puts on a "Mini Med School" series of lectures for the public. If you don't live near San Francisco, some of the video are online. One by Dr. Scheinman is here: https://www.youtube.com/watch?v=Fm3SwORdBS4

I wish sites would date their articles. The first ablation in a human was in 1981, ergo more like “45th anniversary”.

One of his protégé’s practices in the peninsula and does ablations for many in Silicon Valley

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