Articles / 2007
Heart 'electrician' joins area hospital
Ventura County Star
By Michelle L. Klampe
Pauline Rojelio had trouble climbing stairs, walking across the Oxnard school campus where she works as a teacher's assistant, even bending over to tie her shoes.
Without warning, her heart would start beating so fast it would feel like it was quivering inside her chest. She'd lose her breath and have to stop what she was doing until her heart rate finally slowed.
"You have to sit down. You can't move," she said. "What would scare me is if I didn't stop, it would get worse."
Rojelio, 58, struggled for years with episodes of the arrhythmia, or irregular heartbeat, which continued to occur despite medication. It was getting worse, too, so her doctor suggested she see electrophysiologist Dr. Ishu Rao, a cardiologist who specializes in diagnosis and treatment of abnormal heart rhythms.
"Cardiologists are the plumbers," Rao said. "Electrophysiologists are the electricians of the heart."
Rao is believed to be the first full-time electrophysiologist based in Ventura County.
He joined Cardiology Associates Medical Group in September and treats patients in a new, state-of-the-art electrophysiology laboratory at Community Memorial Hospital in Ventura.
The lab is equipped with a combination of heart monitors, X-ray equipment and computerized 3-D heart mapping technology and other tools to aid in diagnosis and treatment of electrical problems in the heart.
Common symptoms of such problems might include palpitations or a racing heart that starts or stops suddenly, Rao said.
His work includes installing cardiac rhythm management devices such as pacemakers or defibrillators and using cardiac ablation to halt irregular heart rhythms such as atrial fibrillation and atrial flutter. Ablation procedures and electrophysiology studies are conducted using catheters — long, narrow tubes with electrodes attached — that are inserted into veins in a patient's groin and threaded into the heart so Rao can diagnose and treat problems from the inside.
"It's like looking at a house from inside the living room," Rao said of the view the catheters provide. "We can get detailed information about the electrical structure of the heart."
Community Memorial invested about $1 million to outfit Rao's lab, so the hospital offers a full complement of electrophysiology services to its existing heart program. Electrophysiology is a good companion for the hospital's other heart services, including a cardiac catheterization lab, said Community Memorial President and Chief Executive Officer Gary Wilde.
"As we age in our community, more and more patients are going to have cardiovascular disease," Wilde said. "We have worked very diligently with our cardiologists, our cardiac surgeons and our cardiovascular surgeons to develop a complete service."
The hospital had offered limited electrophysiology services using physicians who would travel to Ventura from elsewhere to see patients, Wilde said, but at a time when demand for electrophysiology is on the rise, much of the work had to be done at labs outside the county. With the arrival of Rao and the launch of the new lab, patients such as Rojelio who need electrophysiology services will be able to receive them locally.
"Dr. Rao has the skill and technology that one typically sees only in advanced academic health centers," Wilde said. "This is a key need in our community."
Rao attended medical school in Philadelphia and did his residency at Baylor University Medical Center in Houston. He spent three years at Harbor UCLA Medical Center as a cardiology fellow, then another year at Good Samaritan Los Angeles as an electrophysiology fellow before going into private practice in Texas.
The job in Ventura County appealed to Rao because it offers a chance to start a new program in an area that has been underserved by the specialty in the past, he said.
"We've probably done more electrophysiology cases in this lab in the last six weeks than they probably did here in the last two years," he said. "It was a great opportunity."
During a procedure, the lab team can include as many as nine people, including Rao, nurses, technicians and an anesthesiologist. Two hospital staff members, nurse Rich Kenny and cardiac technician Junior Nanalis, spent a week at Rao's Texas lab to learn more about electrophysiology procedures so they would be prepared when the new lab opened.
Procedures can last anywhere from one hour to several hours; patients are sedated while the work is under way and spend a night in the hospital afterward so Rao can monitor them. During a study or procedure, Rao can continually test the effectiveness of the treatment.
"We can monitor as we go," he said. "We know here in the lab if we've been successful, which is very rewarding."
Rojelio, the teacher's assistant, was one of the first patients to undergo a procedure in the new lab. She had an unpleasant experience with a previous doctor, but her atrial flutter had grown so bad she was ready to give another doctor — Rao — a chance.
"He listens to me," she said. "He didn't rush me out of his office."
On Oct. 1, she underwent a cardiac ablation. During ablations, up to five catheters are inserted into veins in the groin and threaded into the heart, where they are used to pinpoint and cauterize small areas of heart muscle that are conducting the irregular electrical currents and causing the irregular heartbeat.
The procedure changed Rojelio's life. "I'm sleeping now. I can sleep on my side and not hear the thumping of my heart," she said. "I can go from one end of the school to the other without falling apart. I'm off Coumadin (a blood-thinning medication) now."
"Dr. Rao did a good job. Because of him I'm able to do so much more."