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LIBIN LIFE
Taking it to the next level
Cardiac surgeon uses innovative techniques to improve patient experience By Dawn Smith
I
t has been couple of tough years for Al Cheney, 75. The retired oil and gas worker’s quality of life plummeted since suffering a massive heart attack in 2017. Suffering with symptoms such as an irregular heart beat, swelling and difficulty breathing that made mobility difficult, Cheney was diagnosed with heart failure following the heart attack. He has spent a great deal of time in the hospital – often weeks at a time. Although Cheney’s life improved somewhat after treatment, doctors determined he needed an implantable defibrillator with a special pacemaker lead to help improve his heart function. Cheney received the defibrillator, protecting him from dangerous heart rhythms. However, his cardiac resynchronization therapy implant procedure— which involves adding a pacing lead through the coronary sinus, a special vein in the heart—was not successful because of the anatomy of his heart.
“I was fortunate to have access to the right technology at our institution, which allows us to be innovative.” — Dr. Jacques Rizkallah, MD
However, in August 2019, Cheney’s physician, Dr. Jacques Rizkallah, MD, a young
cardiologist who began working in Calgary in 2016, was able to overcome this using a novel technique known as Left Bundle pacing. It was the first time that this surgical technique was performed in Canada. Rizkallah, who received specialized training at Harvard Medical School, explains that in standard pacemaker implant procedures, doctors insert one or more pacemaker wires into the heart to activate it based on the specific needs of the patient condition. Although the purpose of a pacemaker is to treat patients with slow heart rates, in some rare cases, activating the heart with the pacemaker can cause it to enlarge and weaken. Known as pacemaker mediated cardiomyopathy, the condition is caused by activation of the heart out of sync. In the new approach, also referred to as physiologic pacing, the pacing wire is implanted in a specific part of the heart along its normal conduction system, reducing the risk of pacemaker mediated cardiomyopathy and treating heart failure in some cases. “This allows us to stimulate and activate the heart with the pacemaker the way it is naturally designed to be activated,” says Rizkallah.
