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September 21, 2007
Negaunee man one of few in Michigan to have new heart procedure for atrial fibrillation
Bruce Nelson felt as though he had run a marathon. Only he wasn’t the one who was racing. It was his heart.
“My heart would race up to eight hours, a hundred, hundred and fifty, two hundred beats a minute,” Nelson said. “The next day, I’d be worn out.”
Since 2000, Nelson had experienced increasingly long and rapid bouts of atrial fibrillation, an electrical malfunction in the upper chambers of the heart. During “atrial fib,” the atria begin to quiver instead of contracting in a regular rhythm.
When atrial fib persists, patients are at high risk for stroke or congestive heart failure. Many patients like Nelson must also take anticoagulant medications to prevent blood clots that could cause a stroke.
Nelson, 67, said his atrial fib would start for no apparent reason. At first, it would last for about 10 minutes once every couple of months. As it worsened over the years, he would have episodes once or twice a week for up to eight hours, then lose the next day recovering from his “marathons.”
At first, Nelson’s wife, Joan, thought he might have had too much coffee or perhaps coffee combined with his allergy medication. As his symptoms worsened, Joan became frightened.
“When my husband who normally ‘worked for fun’ would come in all white in the face, totally drained of color and energy and be lying in his chair while the sun was still out, I had to admit that this was a scary serious situation,” she said.
“I would lay my head on his chest to listen and wonder--how is this man alive? What's going to happen? But then in between these spells, life would be normal,” she said, “until the next time it happened.”
Over the years, Nelson had had numerous kinds of tests to rule out other conditions. He had also been on several different medications to minimize the risk of stroke, but each had side effects, and none could treat the source of the atrial fib.
In the spring of 2006, cardiologist Dr. Tom LeGalley recommended that Nelson see cardiothoracic surgeon Dr. Doug Baldwin, who was doing a new procedure called mini-Maze that could cure atrial fib. The first patient to have the procedure at Marquette General in May of 2006, Nelson was also one of the first mini-Maze patients in the state of Michigan.
“People were after me to go to Mayos,” Nelson said. “So I called the Mayo Clinic and they said, ‘You have the same procedure up there, so why would you want to come here?’”
“This procedure was the cure for Mr. Nelson,” said Dr. Baldwin. “In fact, the ‘mini maze’ offers a cure for many atrial fibrillation patients. It also means tapering off and eliminating clot-preventing medications, so there’s no more weekly lab work. Without this procedure, some patients must stay on medications for the rest of their lives.”
Dr. Doug Baldwin
According to Baldwin, who is a partner at Upper Michigan Cardiovascular Associates in the Peninsula Medical Center, atrial fib is an irregular heart rhythm that reduces the heart’s ability to pump blood. Blood can pool in the atria of the heart, allowing clots to form. Clots can travel to the brain, increasing the risk of stroke.
The minimally invasive mini-Maze surgery is done through a scope inserted into the chest between the ribs. With the guidance of a miniature camera inside one of two incisions, Dr. Baldwin uses a clamp to apply radiofrequency energy to create small circles of scar tissue around each of the pulmonary veins. In doing so, he shuts off electrical circuits in the heart that cause the irregular rhythm. The heart’s normal rhythm can resume, and the risk of stroke is significantly reduced.
The hospital stay is typically two or three days, and patients may need up to six months to see the full benefit of the procedure.
Nelson’s heart rate became too slow for a short time after his procedure, and he went back to Marquette General for two days and was on medication for two weeks. Since then he’s been medication free, and jokes about his larger-than-expected two-inch scars from the surgery.
Joan is relieved to see her marathon man devoting his time to the things he loves.
“Thankfully, I no longer find myself in the hallway checking to see if he's still breathing--or waiting during the night for a healthy snore to assure me that's he's alive.” she said. “I'm back to making Bruce a ‘bucket’ (lunch to go) so he can continue with his projects that he loves to do.”
Although he’s retired from his 35-year career as a power company lineman, Nelson has always been a busy man despite his bouts with atrial fib. During retirement, he has been able to spend more time helping older adults who are alone or people who are handicapped by blowing snow, removing trees, doing carpenter work, wiring and doing upkeep at people’s camps or at his church.
Ten months after his procedure, in February 2007, Nelson traveled to Ecuador on a mission trip to help build a church.
Bruce Nelson of Negaunee constructs a church in Ecuador ten months after a minimally invasive heart procedure to cure atrial fibrillation at Marquette General Hospital. (Bruce Nelson photo)
His immediate concern is keeping an eye on the weather so he can finish applying sealant on the driveway of a neighbor who has had a stroke.
“I’m healthy and care about the less privileged, and now I can do more of it,” Nelson said. “Not that I haven’t done it all my life; now I can do more of it.”
Baldwin is one of a handful of surgeons in Michigan to perform the mini-Maze procedure, and has performed more than any other physician in the state.
“Many patients who undergo the mini-Maze procedure have up to a 95% percent chance for a complete cure,” Baldwin said, “We always caution patients that it can take six months for the full effects of the procedure to stabilize.”
A similar surgical technique can also be used as part of more commonly performed “open heart” surgeries such as heart valve replacement or coronary artery bypass. The options provide greater flexibility to treat larger numbers of patients with atrial fibrillation.
According to the American Heart Association, approximately 2.2 million people in the United States suffer from atrial fibrillation. More than 300,000 new cases are diagnosed each year.
The condition carries serious consequences. Atrial fib increases the risk of stroke fivefold, and is a major contributor to the development of congestive heart failure.
“Until now, the options available to Afib patients have been limited. They could be on anticoagulant therapy for life, have a permanent pacemaker or undergo a very complex surgery,” Baldwin said. “With mini-Maze, we can offer patients a much better choice.”
For more information on the mini-Maze procedure, please call the Upper Michigan Heart Institute at 1-800-MGH-HRTS, or Upper Michigan Cardiovascular Associates at (906) 225-3870 or
1-800-628-3333, ext. 3870.
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