I couldn’t sleep. My heart rhythm was in chaos and my mind was racing. I had a resting heart rate of anywhere from 110 to 140 beats per minute. There was no consistency to the rhythm or strength of my heartbeat. I was easily winded doing everyday tasks, felt uncomfortable in my chest, and if I stood up too quickly, I’d get lightheaded. In short, I just felt “off.”
Even though I knew it was atrial fibrillation, which I’d been diagnosed with 18 months ago, the thought of being out of rhythm again worried me. I was physically and emotionally taxed. The electrical chaos going on in my heart was causing chaos in my head and making it difficult to sleep.
I didn’t feel I was in any immediate danger, but I’ll admit I had some what-if-I fall-asleep-and-don’t-wake-up-because-my-heart-throws-out-a-blood-clot-that-causes-a-life-ending-stroke thoughts running through my head. Atrial fibrillation definitely creates some anxiety, to say the least.
What had caused my heart to go out of rhythm this time?
My best guess was stress. While I love running, I don’t run often. When the opportunity came to run a Thanksgiving Day 5k for a project I was coordinating at work, I took the challenge head on – but I probably should have taken some training head on first. I ran the race in 33.5 minutes, capturing the photos and videos I needed for work AND I beat the local mayor to earn myself a medal. But I guess I also won a side dose of chaos.
Three days after the 5k, I was still tired. I attributed it to the pace I kept up in the race. I tried checking my heart rate and discovered I had no rhythm. I even had my wife listen to my heart and she agreed the beats were sporadic and the strength of the heartbeats varied, too. As soon as the Intermountain Medical Center Heart Institute clinic opened on Monday morning, I was on the phone with a nurse who confirmed my fear and I was scheduled the following day to have my heart shocked back into rhythm.
The treatment is known as a transesophageal echocardiogram (or TEE) followed by a cardioversion
In layman terms, they put a scope down my throat to capture images of my heart to make sure no clots have formed in it due to the irregular heart rhythm. If it turns out to be clot-free, they have a pad on my chest and one on my back and they deliver a shock to my heart. Having gone through two of these procedures, it’s not as awful as it sounds – but like anyone who has to get their heart shocked, there’s some anxiety that accompanies the thought of swallowing a tube and getting shocked.
My experience was positive, and I was glad to share it publicly. I’ve worked closely with the team from the Intermountain Medical Center Heart Institute for the past four years in my role as a public relations professional with Intermountain Healthcare.
I’ve helped share new technologies and research that give heart patients a second chance at life, returning to doing what they love with family and friends. But I’d never been involved in sharing information about a TEE or cardioversion, so I arranged for my experience to be shared live on Twitter – including the moment 200 joules of electricity raced through my heart.
The day went something like this
After checking in at the front desk, I was taken to an exam room and put on a hospital gown. I had monitors placed on my chest to follow my heart rate and they took my blood pressure as well. My BP was 115 over 93 and my heart rate was ranging from 110 to 140+ beats per minute, compared to a normal heart rate of 60 to 100.
The next part of the prep work definitely took me out of my comfort zone. I wasn’t a fan of showing the world my chest, let alone having a strip of chest hair shaved off so the cardioversion pad could be positioned. But it was just part of the process. When the teams began to assemble in my room, things started moving pretty fast.
After a brief conversation with cardiovascular electrophysiologist Jeffrey Osborn, MD, he got the process started by giving me some lidocaine to gurgle, swish, and swallow. That helped numb my throat for the TEE. The taste wasn’t bad – but it wasn’t good either. At the same time, fluids were hooked up to my IV and medications were started to help sedate me for the procedure.
The last thing I remember was the doctor asking me to lay on my left side and a nurse placing a pillow behind me to help keep me on my side. I started to feel a little sleepy and shut my eyes, and when I opened them, almost everyone had left the room and my heart rate was hovering around a consistent 90 beats per minute. I was told the TEE was a success, and after sharing a tweet from my personal account that everything went well, Dr. Osborn replied to my tweet: “One shock, that’s all to restore rhythm to normal.”
During the next hour, I looked to see what had been shared on Twitter while I was sedated so I could get a better idea of what happened. After going into light sedation, the scope was inserted into my esophagus and images were taken of my heart, which showed it was healthy (other than the abnormal rhythm) and I had no blood clots.
Once that was completed, 200 joules of electricity shocked my heart back into rhythm. In fact, a short video of the “shocking experience” was posted to Twitter – which prompted some feedback from others around the country:
- Thank you for being willing to share this video! Too many #afib patients see terrifying vids online. This will help so many of us. – Debbe McCall (@DebbeMcCall), a cardiovascular patient researcher and advocate.
- Thanks for sharing the video and the fact sheets. Will be using to educate our patients and hopefully decrease some of the fears and concerns that they have. – Haide Landeros (@hidee27), a nurse practitioner in cardiology in California.
- Only a social media manager would live tweet own cardioversion. Amazing resource for patients. - @JediCath, an interventional cardiologist at Brigham Women's and Deaconess Hospitals in Massachusetts.
- I hope my friends at @Intermtnmedctr don’t mind that I compiled these to make them easier to follow and to use as education for patients? Thanks for live=tweeting your #cvTEE Guided #Cardioversion for #Afib. – John P. Erwin III, MD (@HeartOTXHeartMD), a cardiologist at Baylor Scott and White Health in Temple, Texas.
The idea of getting your heart shocked may sound — well, shocking – but it isn’t anything to be nervous about. I knew I was working with an amazing team of heart experts from the Intermountain Medical Center Heart Institute, and they did everything possible to help me understand the procedure, know what to expect, and ultimately return to doing what I love without worrying about an abnormal rhythm or getting easily winded… although my wife has banned me from running any 5ks in the future.
Here’s a recap of the journey as it unfolded on Twitter.