Wright Brings New Expertise to Gill Heart Institute's Atrial Fibrillation Program

LEXINGTON Ky. (Dec. 10, 2013) -- When healthy, the heart is an organized instrument, using well-timed electrical impulses to contract muscle and send blood circulating through the arteries and veins -- a virtual "supply wagon" that delivers oxygen and nutrients to the farthest reaches of the body. Those electrical impulses occur in a specific order through specific nerve pathways in the heart muscle and within a specific time frame -- what doctors call "normal sinus rhythm." But when disease or genetic abnormalities interfere with these impulses, the heart can misfire and struggle to contract smoothly. Any interruption in the smooth, steady, and constant flow of oxygen-rich blood can make you seriously -- even dangerously -- ill.  

This irregular and often rapid heart rate causes poor blood flow to the body and is known as atrial fibrillation. Atrial fibrillation symptoms include heart palpitations, shortness of breath and weakness.

Dr. Ted Wright's recent addition as a member of the UK Gill Heart Institute team earlier this year, brings a new and important skill to the atrial fibrillation program. With expertise in a wide range of A-fib treatments, Wright and his colleagues are proficient in a number of effective treatment options, some of which aren't available elsewhere in this region.  Furthermore, many of these treatment options are minimally invasive and offer an excellent chance of permanent return to normal heart function without the use of prescription medicines.

Wright uses a simple -- and amusing -- analogy to explain the range of A-fib treatments available through the Gill Heart Institute.

"A woman might have six different pairs of black shoes, but each pair is for a particular type of event, and she can justify owning every single pair," he said. "It's a significant benefit to patients that they can come to Gill and know that we are adept at finding the right fit for their particular set of symptoms and limitations."

Wright is the only physician in the Bluegrass region who performs the latest version of the "MAZE" procedure. The "Mini-MAZE" procedure uses precision radiofrequency energy to create a roadmap of scar tissue in the heart. Since electricity can't pass through scar tissue, the nerves in the heart responsible for the abnormal electrical impulses are blocked, preventing them from "communicating" the wrong message to heart muscle. The procedure is performed on a beating heart, which eliminates the need for a heart/lung bypass machine, and is far less invasive than previous versions of MAZE, requiring a few small incisions in the chest wall.   

"Mini-MAZE is highly effective," Wright says. "My patients are usually able to leave the hospital in two to four days, and more than 80 percent of my patients return to normal sinus rhythm."

While the Mini-MAZE procedure focuses on reorganizing the heart's electrical impulses, other advanced technologies addressWright's second objective: reducing the risk of stroke.

With A-fib, the interruption in the smooth flow of blood causes pooling and clotting in the left atrial appendage, a small pouch connected to the left atrium of the heart.  If a clot forms and subsequently breaks free, it can travel through the bloodstream and block blood vessels in the brain, causing a stroke.

"Thirty-five percent of patients with A-fib will have a stroke in their lifetime," said Wright. "This is a very serious complication, since stroke can be debilitating at its best and deadly at its worst."

UK HealthCare's Gill Heart Institute is the only place in Kentucky where patients have access to two different state-of-the-art therapies to reduce stroke risk caused by atrial fibrillation.  Both procedures focus on ways to prevent blood from pooling and clotting in the left atrial appendage.

The Atri-Clip procedure uses four small openings through the ribs into the chest to deploy a small fabric band around the outside of the left atrial appendage, pulling the appendage closed much like a rubber band is used to make a ponytail in a little girl's hair.

"The Atri-Clip has been used in thousands of procedures around the US in concert with open heart surgery for patients with valve or coronary artery disease, but we are just now starting to deploy it as a sole therapy for otherwise healthy asymptomatic A-fib patients using minor incisions through the chest wall," Wright said. 

The Gill Heart Institute is also the only place in Kentucky where patients can receive a LARIAT. Currently in the FDA investigational stage, the LARIAT procedure uses two catheters (tubes), each fitted with a tiny magnet at its tip. One catheter is introduced into the body through a vein in the groin and the second catheter through a small incision under the ribs. The doctor guides each catheter into position -- one inside the left atrial appendage, and one outside. Once the magnets click together (much like two magnets between a layer of cloth), a tiny "lasso" of suture material is pushed through the second catheter, looped around the opening of the left atrial appendage, and pulled closed like the drawstring on a sack.

Both procedures can be performed on a beating heart, in most cases obviating the need for an open-chest incision and a heart/lung bypass machine.

"Mini-MAZE, Atri-Clip and LARIAT procedures bring more finesse to the treatment of atrial fibrillation and its side effects," Wright said.  "They are minimally invasive and extremely effective."

"For this reason, these treatment options have the potential to be safer, more practical and more economical than traditional medication-only treatment or open heart surgery for ablation and/or to close the left atrial appendage."

Wright's leadership goes beyond providing state of the art treatment for Gill's patients.  He is beginning a two-year term as president of the local chapter of the American Heart Association, where he will be able to act on his interest in educating the community about heart disease and the things they can do to prevent it.

"Because of the disparities in health outcomes in the African-American community, I've started to speak at African-American churches in the area, teaching congregations about the things they can do to affect their own health and avoid the deadly consequences of stroke, heart attack, and diabetes.  It's a wonderful place to reach at-risk populations with our message of prevention," Wright said. "The tips I share with these congregations-- like following a heart-healthy diet, exercising, and quitting smoking -- are second nature to many of us.  But in too many cases this is the first time these men and women have heard this information, because they don't see a doctor regularly -- or perhaps have a doctor at all." 

Wright also serves on the board of the Lexington Art League and co-owns Table 310, a popular downtown Lexington eatery.

"I have been fortunate to live in many nice places, including Lexington.  Now that I've set roots here, I try every day to do what I can to improve the lives of folks in the Commonwealth."