Electrician of the Heart

ALTHOUGH PATIENTS WITH A PERSONAL OR FAMILY HISTORY OF HEART ATTACK OR ARRHYTHMIA (HEART RHYTHM DISORDER) OFTEN NEED SPECIALIZED TREATMENTS THAT REGULAR CARDIOLOGISTS DON’T OFFER, MYRTLE BEACH RESIDENTS WHO HAVE SUCH DISORDERS DON’T HAVE TO TRAVEL FAR FOR TREATMENT.

Jason Goebel, MD, is a fulltime, board-certified cardiac electrophysiologist at Grand Strand Medical Center, specializing in the treatment and prevention of heart rhythm disorders. “The services we provide are not provided by any other hospital in the region,” Dr. Goebel says. “People traditionally had to drive two hours to get these procedures done. Before I came here in 2011, they were doing about 50 EP procedures a year. Last year, we did nearly 800.”

Determining and treating the problem

Electrophysiology studies can find the cause of unexplained fainting or determine if someone needs a pacemaker or defibrillator. For a patient whose heart beats irregularly, too quickly or too slowly, Dr. Goebel implants pacemakers to help their heart function normally.

“We put in the standard type of pacemakers, and we also put in cardiac resynchronization devices, which are also called biventricular pacemakers,” Dr. Goebel says. “Those specifically are shown to improve heart-failure symptoms in a select group of people, increase life expectancy and drastically improve quality of life.”

Defibrillators are placed in patients who have survived cardiac arrest or who are at very high risk of cardiac arrest. A defibrillator senses when the heart beats abnormally and delivers a shock to correct it.

“The #1 risk factor for cardiac arrest is a heart attack,” Dr. Goebel says. “Years later, these patients may have cardiac arrest. This affects about 400,000 Americans a year.”

Dr. Goebel implants standard defibrillators and biventricular pacemaker defibrillators, which can improve heart-failure symptoms in certain patients.

“Without a defibrillator, the survival rate is between 2 and 4 percent,” he says of patients with a high risk of cardiac arrest. “Putting in a defibrillator can have a very significant benefit.”

Dr. Goebel also implants some patients with loop recorders, which can diagnose problems like skipped heartbeats or fainting episodes when other monitoring methods have failed. “It can monitor the heart for three years,” Dr. Goebel says. “The likelihood of it detecting an abnormality is very good, compared to just wearing a monitor for 24 hours. We’re using this to diagnose strokes of unknown cause at Grand Strand. Atrial fibrillation is the cause in about one-quarter of patients and finding out can reduce their chances of having another stroke.”

Sometimes, people have arrhythmias because of abnormal tissue within the heart. During an ablation, Dr. Goebel threads a catheter through a vein in the groin or neck to reach the heart and cauterizes the abnormal tissue to reverse the problem. “This year, we started doing cryo-balloon ablation for atrial fibrillation, which reduces complications by a third and shortens the procedure time by an hour with the same or better results,” Dr. Goebel says.