Patient Story: Robyn Erbe-Hilfiker
“They felt like something fluttering in my chest, like a moth flapping his wings around,” said the 38-year-old woman from Red Bank. Heart palpitations — rapid, fluttering or pounding heartbeats — are usually harmless. But for Ms. Hilfiker, they were a symptom of several serious heart problems. Although she had been to cardiologist after cardiologist growing up, none had been able to help her, until she went to see Zyad Younan, MD. Dr. Younan is an electrophysiologist (a cardiologist who specializes in abnormal heart rhythms) and an attending cardiologist at Robert Wood Johnson University Hospital (RWJ), one of the nation's top hospitals for heart care.
Dr. Younan recommended an electrophysiology study to find the cause of the heart palpitations and, if possible, fix it. During the study, done through a catheterization procedure, Ms. Hilfiker’s heart suddenly stopped. Her breathing stopped too, and she lost consciousness. “If this had happened outside of the hospital, her heart would have stopped suddenly and she may not be here with us today,” said Dr. Younan. He saved Ms. Hilfiker’s life by shocking her heart (defibrillation) to stop the very fast irregular heartbeat that had caused the sudden cardiac arrest and bring her heart back to its normal rhythm.
Once Ms. Hilfiker was stable, Dr. Younan continued the procedure, inserting long thin tubes (catheters) into groin arteries and threading them to the heart to record the electrical activity and pathways. He found that Ms. Hilfiker had supraventricular tachycardia, a very fast irregular heartbeat. Dr. Younan fixed this by using radiofrequency energy (ablation), delivered through a catheter, to destroy a tiny area of heart muscle, which stopped the electrical impulses causing the problem. He used a state-of-the-art Stereotaxis system in which magnets helped him steer the catheter to precisely the right spot. “Stereotaxis is safer and more stable than manual ablation,” said Dr. Younan. RWJ is one of a few hospitals in New Jersey offering this technology.
To find out why Ms. Hilfiker almost died, Dr. Younan ordered more tests, including an MRI, a catheterization of the heart’s arteries and a CT scan. The results showed that Ms. Hilfiker had a rare and — serious — problem: her left coronary artery was connected to her pulmonary artery instead of her aorta. Her heart was not getting enough oxygen-rich blood. “Most people with this type of problem end up dying in infancy or early adolescence for an unknown reason,” said Shaddy Younan, MD, (Zyad’s brother, and also an attending cardiologist at RWJ), who did the catheterization.
Ms. Hilfiker also had Brugada syndrome, a potentially life-threatening problem with her heart rhythm, and scar tissue from a heart attack she never knew she had. She needed open-heart surgery to interrupt the abnormal connection of the left coronary artery to the pulmonary artery and establish normal heart circulation. She also required an implantable cardioverter-defibrillator to protect her from sudden cardiac arrest, which Brugada syndrome and the scar tissue could cause.
Mark Anderson, MD, FACS, Professor of Surgery and Chief of Cardiac Surgery and Minimally Invasive Cardiac Surgery at UMDNJ-Robert Wood Johnson Medical School and RWJ performed the procedure. A few days later, Dr. Zyad Younan put the implantable cardioverter-defibrillator in Ms. Hilfiker’s chest. The small device monitors her heart’s rhythm and delivers electrical shocks as needed to control abnormal heartbeats. “If Ms. Hilfiker was left alone, she would have developed heart failure or died of an arrhythmia,” said Dr. Anderson. “The physicians at RWJ are very familiar with adult congenital cardiac problems.”
“This device in my chest and the scar will make me stronger in the long run,” said Ms. Hilfiker, who was married in November 2011. She and her husband look forward to starting a family thanks to the cardiac team at RWJ.