Keeping up with the grandkids

Dan Fulford fishing with his grandson.When Dan Fulford needed heart surgery in August 2010 to stop his atrial fibrillation, he didn’t mind that he would be only the third person to undergo a hybrid Mini-Maze at the hands of a UF cardiac surgeon and an electrophysiologist .

“My wife wanted me to go visit other hospitals and get other opinions, because she was a little worried,” he said. “I was very comfortable with what I was being told — very comfortable with Dr. Beaver.”

Fulford, a consulting civil engineer, had suffered from a constantly skipping, racing heartbeat since 2004. He took a blood-thinning medication to prevent blood from pooling in his heart, then clotting and causing a stroke. His medication regimen also included several beta blockers to slow his heart rate and anti-arrhythmia medication. He was too tired to function normally, much less keep up with his energetic grandchildren.

“I’m very athletic, outdoorsy and just all the medicines I was taking fatigued me very fast,” Fulford said. “I couldn’t walk up a flight of stairs without stopping and catching my breath. I was just tired of taking all the medicines and tired of feeling like that and wanted to get back to a, quote, more normal lifestyle.”

A friend who had undergone a different operation at UF&Shands to treat atrial fibrillation first told Fulford about Thomas Beaver, M.D., M.P.H., an associate professor and director of minimally invasive cardiac surgery at UF&Shands. After two meetings with Beaver, Fulford decided to schedule the surgery.

A hybrid Mini-Maze combines components of two other procedures to eliminate problem spots inside and outside the heart that can lead to atrial fibrillation. William M. Miles, M.D., a professor of medicine in the division of cardiovascular medicine and director of clinical cardiac electrophysiology at UF&Shands, collaborates with Beaver to perform this procedure.

To perform the procedure, Beaver creates several small incisions between the patients’ ribs, then inserts radiofrequency tools and a small camera through the incisions. He uses the tools to burn trouble spots from the outside of the heart, and clips the atrial appendage where clots gather to prevent possible strokes. For his part of the procedure, Miles places catheters into veins in the groin, then directs them to the heart. He also uses radiofrequency tools to burn trouble spots from inside the heart.

The two stages of this operation originally were performed as separate procedures. But many atrial fibrillation patients have trouble spots on the interior and exterior surfaces of the heart and, in the past, had to undergo two surgeries to fix the problem. Performing both procedures together allows more patients, like Fulford, to eliminate atrial fibrillation problems with just one operation.

Fulford’s operation was more complicated and took longer than expected because the organs in his chest are abnormally close together. But Fulford said the surgeons and hospital staff did a great job dealing with the challenge and reassuring his wife and daughter while they waited.

“Dr. Beaver came down and talked to them and told them what was going on when his portion of the surgery was done, explained to them why it was taking longer than what they had expected and told them that everything was going fine and I was doing well,” he said. “I had great service, great care from all the nurses and people in the hospital.”

Most importantly, the operation was a success.

“I have not been in atrial fibrillation at all since the surgery,” he said. “I still have fatigue, but it’s because I’m 65 years old. I don’t have the same type of fatigue. It’s been a nice change, and it saves me quite a bit of money because I’m not spending a couple hundred dollars a month on heart medications.”

Freedom from atrial fibrillation allows Fulford to play golf several times a week and to walk the course, as he prefers to do, instead of using a golf cart. He can fish again. And his grandkids aren’t leaving him behind anymore.

“I have two very active grandchildren that I can play out in the yard with, play at the beach with,” he said, “without getting fatigued and having to sit down and rest.”