Dr. Su introduces himself and explains how an electrophysiologist knows he/she is on the correct spot on the heart during a cryoablation procedure.
I am Dr. Wilber Su. I am one of the heart doctors who are a cardiologist here at Banner Good Samaritan Hospital, one of the main institution I work at. And by trade I am a cardiac electro physiologist, or I specialize in electrical abnormalities in the hearts and what makes the heart beats, what makes it go slow and fast. And I am trained in Mayo Clinic in Rochester, Minnesota for eight years and prior to that I actually hold an engineering degree from MIT. So that actually gives a special insight into what I do.
To determine somebody is on the right spot, it really varies, which is why sometimes for example, one of the most common rhythm we ablate is called the AV Node Reentrant Tachycardia, also known as AVNRT. This is the rhythm we ablate right below a critical point called the AV node. If we were to ablate the AV node, it completely cuts off electrical connection between the top and bottom chamber of the heart.
Therefore, if we are to ablate near there, it really varies between people to people, between irreversibility and something that we can consider, gosh, you know, I can basically move closer to the critical point and make sure that I am really done with what I am doing. So cryoablation really allows us to have this type of flexibility or confidence and reassurance that we’re not going to cause any irreversible life-threatening complications.
I think an electro physiologist, any doctor who does this type of procedure, I think they would be lying to themselves if they tell you that they are not nervous when they ablate this type of abnormal rhythm. I’ll be the first to admit that I have caused untoward side effects in young patients when I am using radio frequency, even as careful as I can ever be with six other people watching us ablate. And it’s a team approach, it’s not only the physician. Sometimes the team members will notice any slightest abnormality and stop the procedure, and if we were to go back in time and say, “Well, what was ..” seeing as a potential warning before the complication arose, well, it was only half a second before anything came.
So as fast as we can react and as much I would like to think for the following hour that we waited to see if things reversed, it didn’t reverse, and as with burning. So I think even as quick as we are on that one occasion, complication arose, then it’s one of the accepted complications, but why should we even have to deal with any complication.
So with cryoablation, what we can do is that we can check this abnormal spot and we have sometimes 5, 10, 30 seconds to notice the abnormality, and we can stop the ablation process and allow things to reverse, therefore avoiding a lot of the complications.
Dr. Su, M.D., F.A.C.C.:
Dr. Wilber Su is board certified in Internal Medicine, Cardiology, and Cardiac Electrophysiology, and is on staff at Banner Good Samaritan Hospital, St. Joseph Hospital, Maricopa County Medical Center, St. Luke’s Medical Center, and Banner Desert Samaritan Hospital in Phoenix, Arizona. He received his undergraduate degree with honors in biomedical engineering at Massachusetts Institute of Technology (M.I.T.), and attended medical school at Tufts University School of Medicine in Boston. He also trained at the Mayo Clinic in Rochester, Minnesota in cardiology and cardiac electrophysiology. He is involved in ongoing studies on national trials to improve complex arrhythmia treatments and mentors electrophysiologists across the country on complex ablations and cardiac device implantation techniques. Dr. Su specializes in atrial fibrillation ablation, arrhythmia ablations, Implantable Cardiac Defibrillators (ICD) among other heart conditions and procedures.
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