Robotic Surgery Resets Heart Rhythm

Minimally invasive ablation procedure returns patient's heart to normal rhythm after years of atrial fibrillation

   Becky Elliott started feeling too tired to garden or enjoy her usual activities, due to atrial fibrillation. After undergoing a robotic ablation procedure, Elliott is back to her normal life, including walks in a park near her house.

Becky Elliott of Springfield, Mo., was just 35 when she was diagnosed with atrial fibrillation ("aFib"), an abnormal heart rhythm caused by erratic electrical impulses in the upper chambers of the heart. Her cardiologist in Missouri, a specialist in electrophysiology, managed the condition for more than a decade with anti-arrhythmia medications and cardioversions -- the delivery of electrical shocks to a patient's chest to return the heart to its normal sinus rhythm.

But after 13 years of limited success with different medications as well as ten cardioversions, Elliott and her cardiologist, Keesag Baron, MD, agreed it was time to consider a different solution.

"I started to feel too tired to garden, clean the house and even shower," said Elliott, who had enjoyed body building, camping and hiking before she became seriously ill.

Husam Balkhy, MD Husam Balkhy, MD

Baron referred Elliott to University of Chicago Medicine cardiac surgeon Husam Balkhy, MD, an expert in robotic surgery for the treatment of atrial fibrillation, coronary artery disease, valve disease and other cardiac conditions. "Dr. Balkhy has an excellent knowledge base, is a very proficient surgeon and my patients love him," said Baron, adding that he has been sending his more challenging cases to Balkhy for many years.

"Becky had been completely sidelined in her active life by this arrhythmia," Balkhy noted.

"Her disease and treatment had taken the natural trajectory for atrial fibrillation. The problem with medicines is that 50 percent of the time they don't work and the other 50 percent of the time they work, but with complications. And medications can be cumulative in their toxicity and start to affect other organs."

"Dr. Balkhy explained everything in a way I could easily understand. I wasn't afraid; I was so excited. And I was confident it would work."

In July 2013, Balkhy performed a procedure called endoscopic robotic atrial fibrillation ablation on Elliott. Using the robotic tools of the da Vinci Surgical System, Balkhy accessed the outside of her beating heart through three tiny incisions in her chest. He then ablated, or destroyed, lines along the heart tissue, creating defined scars using a novel dual energy radio-frequency ablation system (Cobra Fusion™). These precise scar lines work to block the erratic electrical impulses of atrial fibrillation and create new pathways for normal electrical activity through her heart.

"Performing cardiac ablation with the robot enables us to fix the problem with more accuracy and to do so without cutting the chest bone or putting the patient on a heart-lung machine," Balkhy said. Because the robot-assisted approach is less invasive, patients recover faster and can return to their normal activities sooner than with open-chest procedures.

Two days after having the surgery, Elliott described how she felt before undergoing the operation. "Dr. Balkhy explained everything in a way I could easily understand. I wasn't afraid; I was so excited. And I was confident it would work."

Back in Missouri, Elliott is now working out in her home gym and recently took a camping trip. Her heart continues to be in sinus rhythm. "I am doing so awesome; it's just so great," she said. The former journalist is planning to return to the pre-nursing classes she started before she became too sick to work or attend school. "I hope to become a cardiac nurse and to help others," she said.

October 2013