AND THE BEAT GOES ON...: NEW PROCEDURE CURES SOME HEART ARRHYTHMIAS

When Shane Steck ran junior high track he spent more time lying down than running. The same was true when he attempted soccer.

"Anything I did that was athletic, my heart would race and I had to lay down," Steck said. "It would last a couple seconds to 45 minutes. I didn't know how long it would last."

Sometimes his heart raced when he was sitting still.

The arrhythmia Steck was born with caused his heart to beat up to 300 times a minute. A normal heart rate is generally between 60 and 100 beats per minute.

"Sometimes I could get away with things," he said. "It wouldn't happen all the time, but it was a nuisance. I never knew when it would happen."

So Steck replaced athletic activity with playing the piano. As other children ran through the neighborhood, he sat at the keyboard developing a love of music.

At age 19, Steck learned of a new treatment that could cure his arrhythmia called electrophysiology.

Only recently has electrophysiology, a sub-speciality of cardiology, been taken out of the university setting to communities. In Cape Girardeau, St. Francis Medical Center and Southeast Missouri Hospital have collaborated to offer the service.

Dr. Richard Klonoski, an electrophysiologist, heads the program along with team members Bob Dykes and Terry Snider from Southeast and Dianna Johnson from St. Francis. The lab is currently housed at Southeast.

Electrophysiology studies electrical pathways through the heart. Irregular pathways cause arrhythmia.

"The exciting thing is that patients can be cured right in the lab," said Ruth McDonnell, director of the St. Francis Heart Institute at St. Francis.

The procedure includes two steps. First, the arrhythmia is studied. Computers may be used to develop a map showing how electricity travels through the heart.

Patients with specific kinds of arrhythmia may be candidates for radio-frequency ablation. "Basically, we burn a section of the heart, causing a scar," McDonnell said.

The heart's electrical pulses won't travel through the scar tissue. The arrhythmia is cured.

Ninety percent of patients see positive results after a single procedure, said Klonoski.

"Of the 10 percent who aren't cured the first time, we still learn a lot about their tachycardia (fast heart rate)," Klonoski said. "Ablation is actually a very effective procedure. Once you get it, you're cured. You don't have to worry about medications or attacks anymore."

Before the service was offered in Cape Girardeau, patients were referred to St. Louis or Memphis. Local cardiologists thought some 100 patients a year would be candidates for the procedure.

"Although both hospitals could have established individual programs, it was determined that it was better to begin with one strong program until such time that a second program could be justified," said Southeast Assistant Administrator Richard Meyer.

In addition, collaboration offers expertise from both hospitals for the project.

The computer mapping showed that Steck had two extra electrical pathways in his heart.

After hearing the plan to zap his heart with radio waves and cause permanent scars, Steck didn't hesitate to say yes. "It sounded like a fine plan to me," he said. "It was a chance to be cured."

Steck watched the procedure on a monitor and asked questions. When the surgery was complete, he asked his mother to bring Chicken McNuggets from McDonald's to the recovery room. The next day he left on a trip to Kansas.

"I can go out run and exercise and not have to worry about it," Steck said. "I don't get tired as easily, and I know my heart's not going to race any more."

He works two jobs and is pursuing a music career. Steck hopes to be a pianist for a Christian music singer in Nashville.

"I've been playing piano all my life," he said. "I think I have the talent to make it all the way."