Patient Returns to School Symptom-Free

Jaden picWhen Jaden Rascon started fourth grade earlier this week, she didn’t have to worry any longer about her heartbeat suddenly racing – thanks to an innovative procedure at CHOC.

“I feel good,” the 9-year-old says. “Before, when my heart would speed up, it was very hard to breathe, and it would give me headaches. But now it’s all gone because I got the procedure.”

Jaden recently underwent an outpatient electrophysiology procedure at CHOC to cure her arrhythmia. The experience was short, non-invasive and – even better – required no radiation.

Her procedure is a landmark achievement that signals a new direction for electrophysiology, a field that has already dramatically changed cardiology.  And now, an electrophysiology procedure with no radiation marks an even safer and less invasive cure for a common ailment.

A three-dimensional image of a heart created by cardio-mapping equipment at CHOC.
A three-dimensional image of a heart created by cardio-mapping equipment at CHOC.

The successful radiation-free electrophysiology procedure is a credit to the skill and expertise of Dr. Anjan Batra, medical director of electrophysiology at the CHOC Heart Institute, as well as the state-of-the-art cardio mapping equipment inside the hospital’s new Bill Holmes Tower.

“This has really changed our field,” Dr. Batra said. “We can do so much more, and do it better and safer. It’s great to be in a field where we not only treat, but also cure. It’s great to help a patient so that they don’t have to see a doctor for the condition again.”

Dr. Batra performed the procedure using a three-dimensional cardio mapping system. The device uses catheters with locator sensors that transmit signals from inside the heart. This allowed Dr. Batra to visualize the beating heart by using these magnetic sources as reference points, rather than relying on fluoroscopy – an imaging technique that uses X-rays to obtain images of internal organs while they’re in motion – to reveal the catheters’ positions.

Just weeks after her procedure, Jaden’s quality of life has already improved.

Last November, Jaden began complaining of a rapid heartbeat, says her mother, Vera.  A normal resting heart rate for children ages 7 to 9 is between 70 and 110 beats per minute, but Jaden experienced a heart rate of 225 beats per minute during one emergency department visit. She was then referred to CHOC, and was subsequently determined to be a good candidate for an electrophysiology procedure.

“I was nervous at first,” Jaden says, “but then I knew that they were studying the heart for a long time so nothing would go wrong.”

Typically, up to three patients are diagnosed with arrhythmias each day at CHOC, Dr. Batra says.  About 25 years ago, the only cure for these conditions was open heart surgery, and many patients simply tolerated the condition or relied on medication.

Now, the hospital has used electrophysiology procedures to cure more than 100 children with arrhythmias each year, and that figure is expected to increase as awareness grows among parents and the medical community, says Dr. Batra, one of about 200 pediatric electrophysiologists worldwide.

Learn more about CHOC’s electrophysiology services.

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CVICU Provides Special Post-Procedure Care to Heart Patients

Patients who have undergone complex, cardiovascular procedures at the CHOC Heart Institute require specialized care and attention. At CHOC, they get just that in a dedicated, 12-bed Cardiovascular Intensive Care Unit (CVICU).

In CHOC’s CVICU, children receive attention from pediatric cardiac-trained intensivists, nurse practitioners, critical-care registered nurses, and an interdisciplinary medical team. All rooms are private and fully equipped with leading-edge technology that meets the demands of monitoring and treating children with heart problems, and those who have undergone complex heart surgery and heart catheterization procedures. CHOC is the only facility in Orange County that performs open heart surgery on newborns and children.

That combination of well-trained experts and topnotch facilities can lead to improved patient outcomes. The Heart Institute has outcomes above the national averages for overall survival rate and neonatal survival rate. CHOC is routinely named to the Leapfrog Group’s annual list of Top Children’s Hospitals, recognizing a commitment to provide the safest and highest quality of health care.

“Cardiovascular patients are unique and delicate. They require complex care and management. CVICU staff members understand these kids’ physiology,” says Allie Quill, RN, a clinical outcomes coordinator at CHOC. “When our patients get into trouble, their treatment is not routine. All of our kids are so different and require such fine tuning.”

CVICU care team

Cardiac pediatric subspecialists are especially trained to care for heart patients in need of critical care, and they have advanced knowledge of cardiovascular disorders.

“Pediatric heart specialists have extra training and experience in caring for children with unique and severe cardiac disorders, something a general care team or an adult cardiac doctor may not be as comfortable with,” says Dr. Michele Domico, medical director of the CVICU.

The CVICU’s design also plays a critical role in improving outcomes for patients. The space encourages parent-clinical caregiver interaction, and ensures a peaceful, healing environment.  Our staff recognizes the role that loved ones play in patient healing.

Each private CVICU patient room is divided into three areas:

  • The first area, closest to the doorway, is the nurse’s zone. Here, visitors will notice a wheeled cart that holds a computer and supplies to allow bedside charting and full access to patients.
  • The second area belongs to the patient, and features gas hook-ups, monitors and other equipment.
  • The third area is the parent zone, which includes a sleep sofa, reading light, sink, telephone and other amenities to ensure family comfort.

The CHOC CVICU also includes two fully-equipped procedure rooms that allow physicians to perform life-saving surgery on patients who otherwise could not be transported out of the unit.

Certain heart conditions warrant a series of surgeries throughout childhood, necessitating several stays in the CVICU. For that reason, CVICU staff members often develop close and lasting relationships with patients and families.

“Parents often come back and visit us after their child has been discharged, to thank us for taking special care of their child,” says Domico. “Every year our team receives dozens of school photos and holiday cards from families who we were fortunate enough to bond with in the CVICU. It’s a privilege to see the children we’ve treated grow up and have a healthy childhood.”

Learn more about CHOC’s CVICU.

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Melody Therapy at CHOC Improving Lives For Patients With Heart Disease

In honor of American Heart Month, we’re highlighting the CHOC Children’s Heart Institute including stories of our brave patients, as well as our amazing experts and some of the cutting-edge procedures they are using in caring for infants and children with heart defects/disease.  We recently spoke to Dr. Farhouch Berdjis, medical director of the CHOC Cardiac Catheterization Lab, about the new Melody Transcatheter Pulmonary Valve (TPV) Therapy, a less invasive procedure which can delay the need for open heart surgery.

Q: How do heart valves function?
A: The heart has four chambers. As the heart beats, normal heart valves repeatedly open and close fully to ensure that blood flows forward through the heart’s chambers. A narrowed or leaky heart valve can cause dizziness, chest pain, weakness, and can lead to serious medical problems.

Q: What is the Melody therapy and what makes it so unique?
A: The Melody therapy treats narrowed or leaking pulmonary valve conduits without open-heart surgery. With this therapy, a thin, hollow catheter or “tube” holding a specially designed heart valve is inserted into a child’s vein in his leg and guided to his heart. The heart valve is attached to a wire frame that expands with the help of a balloon to push the child’s blocked pulmonary conduit open. CHOC is one of a few hospitals in the United States currently using this state-of-the-art, FDA- approved procedure to treat the pulmonary valve.

Q: How will patients and families benefit from this procedure?
A: This therapy can be an alternative to surgery for some children who have already undergone previous heart surgeries. Patients can expect less scarring, less stress to their circulatory system, and an overall speedy and positive recovery both physically and emotionally.
To learn more about the Melody therapy, please contact Dr. Berdjis’ office at 714-547-0900. To learn more about the CHOC Children’s Heart Institute, click here:

CHOC Leading the Way in Prevention of Sudden Cardiac Arrest in Children

The sudden death of a child and/or athlete is a tragic yet rare occurrence that causes significant concern in both the general public and medical community.  Strategies to prevent these catastrophes have become a prominent public health debate. To address this critical topic affecting our young athletes, a symposium on the diagnosis, therapy and prevention of sudden cardiac arrest (SCA) in children and adolescents is being planned at Disney’s Grand California Hotel and Spa in Anaheim for January 14-15, 2011.

We spoke to Dr. Anjan Batra, medical director of electrophysiology at the CHOC Children’s Heart Institute, about the importance of this event:

Q: What will be presented at the Sudden Cardiac Arrest Symposium?
A: Topics will include clinical syndromes associated with the risk of sudden death, arrhythmias in the young, use of automated external and implantable defibrillators in children, and screening, with an emphasis on defining levels of evidence and areas of controversy in management decisions. It will be open to pediatricians, pediatric cardiologists, electrophysiologists and affiliated professionals involved and interested in the care of young people, including the general public.

Q: What message do you have for Orange County families about this topic?
A:  Orange County has an estimated population of just over 3 million, making it the second most populous county in California, behind Los Angeles County. It is also the county with the highest per capita of National Collegiate Athletic Association (NCAA) and Olympic athletes.  This may be one of the reasons for what appears to be a heightened awareness for the prevention of sudden cardiac death in young athletes in Orange County.

Q: What warning signs should parents look for that suggest their young athlete may have a heart problem?
A:  Certain symptoms can suggest that your child or teen has a heart problem that needs a doctor’s attention. This is especially true if symptoms occur during sports or other activities. It’s important to ask if your child has:
* Been dizzy or light-headed?
* Passed out, or nearly passed out?
* Had chest pain or pressure?
* Felt like his heart was racing or skipping beats?

Talk with your doctor if your child experiences any of these symptoms, which may put your child at risk. Keep in mind that these signs do not necessarily mean that your child has a heart problem. For example, a child who faints during sports may have low blood sugar or other temporary problems. A doctor can help find the cause.