A frequent swimmer and avid Gator fan, Mrs. Prevost continued her regular exercise routine and attended Gator football games, just as she always had.
But the intermittent racing and skipping of her heartbeat, caused by erratic electrical signals sent from the heart’s atria, or upper chambers, to the lower chambers, known as ventricles, was getting worse.
“I felt it in my throat,” she said. “I could feel the fluttering. Even to this day, I could sit here quietly and tell you what my pulse is, because I could just hear it in my ear, racing really fast and skipping.”
Atrial fibrillation also can cause blood to pool in the atria, raising the risk of blood clots forming in the heart and migrating to the brain, where they cause stroke. To prevent this from happening, Prevost took Coumadin, a blood-thinning medication commonly prescribed for atrial fibrillation patients.
When Prevost contracted a virus and came down with a fever, it sent her heart into a tizzy. Her heart rate reached 200 beats a minute — far above her normal rate of about 60 beats per minute.
After that incident, she underwent a procedure called catheter-based ablation, a minimally invasive technique in which a cardiologist places catheters into veins in the groin, then directs them to the heart. The doctor uses radiofrequency tools to essentially burn trouble spots inside the heart that can contribute to faulty electrical signals and atrial fibrillation.
The procedure went smoothly and reduced the frequency of Prevost’s atrial fibrillation episodes, but she continued to have them a few times a month. Between 10 and 50 percent of patients who undergo catheter-based ablation for treatment of atrial fibrillation find the procedure does not fully fix the problem, according to the American Heart Association, and require additional treatments to eliminate the condition.
The atrial fibrillation episodes Prevost still experienced were enough of a problem that she still had to take medications to deal with them. Sometimes, she cut her exercise routine short because of her heart’s racing and skipping.
When Prevost took a few doses of a medication to treat ringing in her ears, she had a terrible reaction. The medication interacted with flecainide, a medication she took to combat irregular heartbeats, and triggered an especially bad episode of atrial fibrillation. She went to Shands at UF, where doctors admitted her.
While in the hospital, Prevost requested a visit from Thomas M. Beaver, M.D., M.P.H., an associate professor of surgery at UF and director of minimally invasive cardiac surgery at UF&Shands. Together, they decided she would be a good candidate for a thoracoscopic Mini-Maze, an operation which requires a surgeon to make several small incisions between the ribs. The surgeon then inserts tools and a small camera through the incisions and burns trouble spots from the outside of the heart, and clips the atrial appendage where clots gather, prevent possible strokes.
Since this second operation, which Beaver performed in August 2009, Prevost has not experienced atrial fibrillation. She said her pulse still rises sometimes, but quickly is brought into check by the modifications Beaver made to her heart during the surgery. She no longer takes Coumadin or flecainide.
“I wanted to do (the Mini-Maze surgery) and it’s made me able to do everything that I want to do,” Prevost said.
“On my first year anniversary (of the operation) I sent Dr. Beaver a birthday card, and told him he had given me a second birthday to celebrate every year, because it was like a whole new life.”