OUT OF RHYTHM
Smartwatch helps Houston man in his fight against irregular heartbeat
Nights were hard for Anthony Purser — as soon as he laid down to sleep, his heart began dancing in his chest. During the day, Purser’s heartbeat remained steady as he worked around the house. But as the sun went down, it ratcheted up.
“It’s not a good feeling. You’ll have a steady beat for a minute, and it’ll jump and quickly have some rapid beats,” said Purser, 65. “There’s a lot of rapid beating, not even a pattern to it. It might be rapid, then it slows down, and then it’s rapid again.”
He didn’t know it yet, but Purser was suffering from atrial fibrillation (Afib), the most common cause of arrhythmia — or irregular heart rhythms — in the U.S., and an underlying cause of death for 26,000 Americans in 2018.
When his heartbeat became irregular during the daylight hours, Purser’s cardiologist, Dr. Dipsu D. Patel, suspected he may be experiencing Afib, but the condition was difficult
to track during his appointments. Patel suggested he wear an Apple Watch, which has an electrocardiogram (ECG or EKG) feature, to monitor his pulse.
Purser had a smartwatch before, but he’s “not really very good with technology,” so he barely used it. But the concept seemed simple enough: When his heart began beating irregularly, Purser could turn on the ECG function on the watch, which would document his heart rate for 30 seconds, and store the results.
After being diagnosed with Parkinson’s disease in 2014, Purser began taking Rock Steady boxing classes at Anytime Fitness Clear Lake West. Rock Steady was developed to help Parkinson’s patients retain or improve their movement. During class, athletes are tracked with a heart rate monitor to ensure they’re not overexercising, said Armin Smith, Rock Steady instructor and fitness trainer.
Despite his heart issues, Purser never sat out, but he also didn’t overexert himself, Smith said. In fact, Smith said he was impressed with his cardio output and wouldn’t have guessed he had heart problems. Purser ate heart-healthy foods and worked out regularly, but by summer 2020, his jumping heartbeat was nearly constant.
His heart felt like a roller coaster in his chest — sometimes he didn’t feel it at all, and he thought everything was OK. But those times shortened. Soon, he felt the arrhythmia more than he didn’t.
After a few weeks, Purser downloaded and printed his ECG reports to
bring to his cardiologist, who then referred him to Dr. Saumya Sharma, cardiac electrophysiologist at HCA Houston Healthcare Clear Lake.
Sharma’s concern for Purser’s heart went beyond the arrhythmia, he said. Since Purser already had a heart attack in 2008, the irregular beating of his heart would continue to damage it over time.
Completely normal hearts can experience Afib symptoms like chest discomfort, shortness of breath and blood clots. One in 7 strokes are attributed to the condition if left untreated.
“There are no clear-cut genetic causes for Afib; it’s really a condition that is somewhat of a mystery as to why it occurs,” Sharma said. “Patients who have cardiac disease develop Afib, but some endurance athletes have it as well.”
Purser does have a family history of heart disease. His father had multiple bypasses in his late 50s and early 60s, but his symptoms only included chest pain — not Afib. Purser’s mother had peripheral artery disease, which affected the arteries near her ankles. She eventually had surgery to unclog those arteries, but she always had pain.
“That’s the scary part — the anxiety you get when you’re worried about it doesn’t help your heartbeat,” Purser said. “So you start worrying about a stroke, and that will mess up your heart to begin with. Add Afib to it, and I was a mess.”
Four days before Christmas, Sharma performed an ablation on Purser’s heart — a cardiac procedure that scars and destroys tissue in the heart to disrupt electrical signals causing arrhythmia. Sharma made a small incision in Purser’s groin area and used catheters to navigate through Purser’s veins, toward his left atrium — where a majority of irregular heartbeats originate. There are four blood vessels and a series for muscle fibers and pulmonary veins in that chamber that work together to induce Afib, Sharma said.
Sharma cauterized the tissue around the pulmonary veins in the left atrium, creating a barrier so that when the upper heart chambers begin beating irregularly, the electrical impulses are trapped inside. Afib can be cured if an ablation is performed early enough, he said.
“It’s like capturing a forest fire,” Sharma said. “Sometimes you have to burn the brush around the forest fire to trap it. If it’s completely trapped inside, it can’t spread and it extinguishes the fire over time.”
His smartwatch continues to monitor his heart rate for any irregularities. In the two months since the surgery, he has had no problems and has returned to virtual boxing class. With access to an ECG on his wrist, he feels empowered to take control of his health rather than feel stress, which can make any problem worse.
“I’m able to measure my heart, look at the heart rate and see if it’s going too high,” Purser said. “It brings comfort and understanding to what I’m going through.”