When all is well the heart has a regular thump-thump, thump-thump, thump-thump rhythm.
An electrical problem in the heart, or "short circuit," can cause that rhythm to go off beat. And Dr. Xiaoke (Ken) Liu can fix it.
Liu, one of 16 doctors at Borgess Heart Center for Excellence, practices electrophysiology. That is to say, he specializes in the intricate electrical problems that cause abnormal heat beats.
Electrophysiology is one of the fastest growing of all cardiovascular specialties. Cardiologists who have additional education and training in the diagnosis and treatment of abnormal heart rhythms are called electrophysiologists. They work closely with other doctors who treat patients with heart disease.
This year Liu became the first local doctor to offer an advanced radiofrequency catheter abalation procedure for cardiac rhythm disorders in Kalamazoo. It's a treatment that residents of Southwest Michigan might expect to travel to the Mayo or Cleveland clinics to obtain were it not for doctor Liu's practicing in the area.
Simple ablations have been performed locally for some time, but complex ablations like those Liu does typically are performed only at major academic institutions.
During an ablation one or more flexible, thin tubes, or catheters, are guided via x-ray into the blood vessels, usually through the groin. The catheters are directed to the heart muscle.
Electrodes on the tip of the catheters gather data that allows the physician to pinpoint or "map" the exact location of the electrical problem. Once the mapping process is finished, radiofrequency energy is delivered through the catheter to destroy -- or ablate -- a very small amount of tissue causing abnormal electrical signals.
Scar tissue forms as the area of ablation heals. The disturbance of electrical activity ends and the heart returns to a regular rhythm.
Most ablations are performed on the upper chambers of the heart, but they also can be performed on arrhythmias that originate in the heart's lower chambers. The treatment also can be used for both rapid heat and slow heart arrhythmias.
The patient is sedated throughout the minimally invasive procedure.
"It's very rare in medicine that we have a real cure," Liu says. "These cardiac cases are the exception. We can be confident we do have the ability to fix it."
The ablation often eliminates the need for open heart surgery and even long-term medication therapies.
The newest aspect of the procedure is an addition that may ultimately be found to be safer for Liu and other doctors who use radiation in the operating room. Borgess recently obtained a special suit to replace the heavy lead aprons used for radiation protection necessitated by the use of fluoroscopy, or x-rays, to guide the insertion of catheters.
Looking a bit like something out of a science-fiction movie, the ZeroGravity Radiation Protection System, created by CFI Medical Solutions in Fenton Mich., bears the weight of the protection system so it does not bear down on the physician as lead aprons do.
The new system features a base unit that resembles a crane. It supports and allows a second component, the radiation protection suit, to move around. The system features a lead apron that is 1 millimeter thick, twice the thickness of the usual standard lead aprons. In addition, this system offers front and side protection as well as protection over the whole head.
In procedures that go on for hours, such as atrial fibrillation ablations, the lead apron can take a toll on the doctor's back shoulder. Liu says his back feels better since going to the ZeroGravity system.
When Liu completed his training at Mayo Clinic in Rochester, Minn., he could have continued to practice there had he wanted to.
But he says the opportunity to practice at Borgess was appealing because of the hospital's good reputation, its well-equipped lab and good people to work with. He says he knew he wanted to stay in the Midwest and Kalamazoo's midsize community was attractive.
There also was little work being done of the kind for which he is becoming known. "There was a huge potential need for people doing ablations," Liu says.
His work also encompasses implanting devises commonly known as pace makers and teaching his expertise to medical students.
"I find it rewarding," he says, "teaching them and helping them develop as doctors."
Liu began his medical training at Hunan University in China. He followed his career path beginning in high school after family members began experiencing health problems.
A teacher at Hunan University from the U.S. encouraged him to continue his education in this country; he then pursued his particular interests first at Georgetown and then at Mayo.
Today he is known among his co-workers for being a regular guy -- his family car is a minivan -- doing extraordinary work.
His patients appreciate his willingness to give them time to explain their situations and admire his self-effacing style.
Liu is part of a team that performs more than 7,000 cardiac procedures and 2,600 cardiac interventions are at the Borgess Heart Institute each year.
Patients have access to the latest procedures and technologies available in the hospital's cardiovascular lab, which features five state-of-the-art cardiac suites. Borgess Health Alliance
also has been named a Top 100 Cardiac Hospital, as designated by Solucient in 2006 and renewed in 2007.
Kathy Jennings is editor of Southwest Michigan's Second Wave Media and a freelance editor and writer.