Picture a fly swatter. Based on its design, it’s easy to understand why we’d pick it over a pencil to swat flies. The “Grid” is no different. This new technology improves on a process that before, as Randall Bryant, MD, a pediatric electrophysiologist (a cardiologist who specializes in treating arrhythmias) at Atrium Health Levine Children’s Hospital (LCH) and Sanger Heart & Vascular Institute (SHVI) says, made mapping arrhythmias “like looking for daisies in a minefield.”
In short, an arrhythmia is an irregular or too fast or slow heartbeat. The Grid, also known as the high-density grid mapping catheter, is a curative procedure that helps doctors map arrhythmias more effectively and in less time. It eliminates heart patients’ needs for radiation, surgery, long recovery times and even medication. As you likely guessed, parents of pediatric heart patients, patients themselves and their doctors love this new technology.
In August of 2018, Levine Children’s Hospital and Sanger Heart & Vascular Institute became the first lab in the region to use the high-density grid mapping catheter to ablate an incisional “scar” flutter in a post-operative adult congenital heart patient. That scar flutter belonged to Bradley Cox, a 25-year-old man whose heart rate remained at 198 beats per minute even hours after he’d completed his strenuous exercise. For reference, a typical resting heart rate is 60-100 beats per minute.
For Brad, and for other patients who receive the same procedure, the Grid cured his arrhythmia. That’s a big deal because it means he’ll avoid heart failure that could have been caused by that particular arrhythmia. Going forward, barring other complications from his condition, he’ll have more energy to live life and do the things he loves to do.
For Heart Patients, Eliminating Problems as They Arise Is Key
Brad was born with a rare congenital heart defect called congenitally corrected transposition of the great arteries (CCTGA). Put simply, his heart twisted in the wrong direction as he was developing in the womb, reversing his ventricles and causing other heart malformations. Brad had his first open-heart surgery when he was 15. When he was 18, he had his aortic valve repaired, and when he was 21, he had it replaced. At that point, he had a pacemaker installed to help his heart’s top and bottom chambers communicate effectively.
Brad’s heart condition has obviously shaped his life. Growing up, he had low endurance. He would run upstairs and be out of breath. At times, he had blue lips and fingernails. He couldn’t play football or basketball, and in baseball, he jokes, he was relegated to the outfield, the place where few balls would fly.
Not being able to participate in those events with friends was, as Brad says, “terrible.” He had to turn to less strenuous activities — skateboarding, riding dirt bikes, hunting and fishing — to satisfy his needs for physical challenge and time spent hanging out with friends. While he enjoyed those activities immensely, he’s aware that his heart condition has affected what he does, for how long and even with whom.
Without new technologies like the Grid, Brad and other heart patients face increasing limitations as their heart conditions run their course. Left untreated, a heart flutter and other arrhythmias deplete energy and can lead to heart disease and even death. Thus, treating arrhythmias is critical to short- and long-term health living a normal life.
Old Technology Forced Doctors to Take a Fingers-Crossed Approach
In what’s considered a curative technology, the Grid transforms what has thus far required doctors to take a fingers-crossed approach. As many congenital heart patients have had surgery, their hearts have crevices, creases and scars that make it difficult for doctors to find pathways that produce arrhythmias. Historically, old technologies meant that mapping arrhythmias could take anywhere from one hour to twelve hours, depending on the conditions. Upon completion of the procedure, there was no guarantee that the arrhythmia was successfully or permanently ablated.
You can imagine, or perhaps know for yourself as a heart patient, how frustrating that would be for everyone involved.
Using the Grid, doctors can map hundreds of points in just minutes. They can easily access and ablate an arrhythmia. And they can do so through the veins in the groin without the need for another surgical incision. For Brad, the procedure was next to invisible amidst other treatments he received at the time.
Arrhythmia-Free
Since Brad’s case, Levine Children’s Hospital has used the Grid for high-resolution mapping of multiple post-operative congenital heart disease patients, both pediatric and adult. Brad, meanwhile, who has always been “fascinated by medicine,” now works at Sanger’s Pediatric and Adult Congenital Cardiology Division. With his college degree in clinical exercise physiology, he conducts stress tests and has patients run on the treadmill. Through his daily work, he can help cardiology patients learn about their conditions and discover how to enjoy healthier, more vibrant lives.
While Brad is busy running stress tests three or four times per week, Dr. Bryant uses the Grid, as he often does on heart patients who have had surgery that resulted in a more complex anatomy. Having performed adult congenital ablations since 1996, he’s overjoyed to be using a much faster, more effective technology to help children and adults with congenital heart disease enjoy good health. Again, Grid patients avoid radiation, painful surgeries, long recovery times and even medications — all things that would be much more of a hardship to young children.
