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Johns Hopkins Health - A Heartbeat Gone Haywire

Summer 2011
Issue No. 13

A Heartbeat Gone Haywire

Date: July 22, 2011

old man

After an irregular heart rhythm struck out of the blue, James Cromwell made a dramatic comeback

I never expected my heart’s steady beat to suddenly go haywire. But an arrhythmia, or irregular heart rhythm, can strike out of the blue, as it did one night in July 2009, just after my wife, stepdaughter and I finished dinner at home in Frederick, Md. As I got up from the table, I collapsed, unconscious. My fast-thinking stepdaughter performed CPR while my wife dialed 911. Once the emergency medical services arrived, they discovered my heart quivered in a rapid chaotic rhythm called ventricular fibrillation. My heart could no longer deliver blood to my brain and muscles, a condition called “sudden death.” The paramedics used an external defibrillator to deliver an electric shock through my chest, restoring my heartbeat’s normal rhythm—for a while.

I was rushed to the ER, where my heart erupted into the same chaotic rhythm 10 times in 45 minutes, requiring more shocks. I was even given my last rites. After I was stabilized, I was transferred to Johns Hopkins, where they used a cooling technique to save my brain function. Then surgeons placed an implantable cardioverter defibrillator (ICD) in my chest. The ICD delivers electrical shocks to the heart, restoring its rhythms, whenever it detects ventricular tachycardia or fibrillation. I also began taking an antiarrhythmic drug called amiodarone, but the ICD still had to send electrical shocks to restore my heart’s rhythm 46 times in four months after I left the hospital. When the device goes off, it’s like a horse’s kick to the chest; I started having panic attacks over when it might go off next.

Then, Dr. Saman Nazarian, a Johns Hopkins cardiologist, told me about a minimally invasive procedure called catheter ablation that’s used to treat arrhythmias, and I agreed to try it. Using an advanced technique, Nazarian pinpointed the origin of my heart’s arrhythmias before he cauterized the area to stop the irregular electrical activity. The procedure was a huge success, and I no longer live in fear of my ICD. My heart’s steady, rhythmic beats are a gift from Johns Hopkins’ talented doctors and medical staff who saved my life.

Understanding Catheter Ablation

  • A cardiac electrophysiologist, using MRI images and electrical signals, pinpoints where the irregular rhythm is originating in the heart and destroys (ablates) a tiny bit of tissue to prevent recurrence.
  • The procedure has an 85 to 95 percent success rate for idiopathic ventricular tachycardia (without structural heart disease).
  • For patients with ischemic ventricular tachycardia (with structural heart disease), the success rate is 70 to 80 percent.

To watch a video of James Cromwell telling his story, visit For more information, appointments or consultations, call 877-546-1872.

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