A special lunch from the heart
Grateful patient thanks VCU Health Pauley Heart Center care team after undergoing cardiac ablation surgery to treat irregular heartbeats.
September 06, 2024
Joey Stemmle bought lunch for members of the electrophysiology care team to thank them for their unwavering dedication to his care after he was diagnosed with AFib. (VCU Health Pauley Heart Center)
By Liz Torrey
The welcoming smell of lasagna, meatballs and other treats lingered in the hallway as small groups from the electrophysiology care team rotated into a conference room.
One by one, they scooped up the warm lunch – something they don’t often get to enjoy during a busy shift at VCU Health Pauley Heart Center.
But this meal was extra special. The lunch was a gift from the grateful heart of Joey Stemmle, who underwent cardiac ablation surgery on February 14, 2024. The procedure treats atrial fibrillation (AFib) – a condition in which the heart beats irregularly or rapidly.
With his Valentine’s Day being spent in a not-so-romantic hospital room, Joey brought sweet treats for his care team and nearly ran out. He was surprised by how many people it would take to heal his heart.
“I don’t think I realized how many people would be back there [in the electrophysiology lab],” he said. “I guess an ablation is not a complex procedure in the grand scheme of all heart procedures, but it’s still a big deal.”
Recognizing the unwavering dedication of the large care team, Joey was inspired to give back and thank them for the care he received before, during, and after his ablation.
“Dr. Jayanthi Koneru, who actually did my ablation, was fantastic,” Joey said. “He was super-nice and explained everything really well – including to my mom, who was asking lots of questions before the procedure.”
Joey is much younger than most patients historically diagnosed with AFib. Last year, not long after he turned 32, Joey was home watching basketball on the couch when suddenly his Apple Watch alerted him that he had a high heart rate.
“I thought, ‘That’s really odd,’” he recalled. “The game wasn’t even a nail-biter. It was just kind of a boring Friday night, and yet my heart rate was bouncing around.”
The proliferation of all these smart devices that are readily available to the consumer and that can record your heart rhythm have partially led to the increased diagnosis of AFib in younger people.
Kenneth Ellenbogen, M.D., director of Clinical Cardiac Electrophysiology and Pacing at the VCU Health Pauley Heart Center
Age is typically the largest risk factor for developing AFib, with the majority of AFib occurring in patients over the age of 65. However, in recent years, AFib has been increasingly diagnosed in younger patients; a recent study indicated that one in four adults living with AFib is under age 65.
“The proliferation of all these smart devices that are readily available to the consumer and that can record your heart rhythm have partially led to the increased diagnosis of AFib in younger people,” said Ken Ellenbogen, M.D., director of Clinical Cardiac Electrophysiology and Pacing at the Pauley Heart Center. “But it’s also due to diet and lifestyle and habits – alcohol, caffeine, sleep deprivation, obesity – as well as sleep-disordered breathing and hypertension. All of those things are leading to an increased prevalence of AFib.”
That said, Joey had been leading an active lifestyle: he plays volleyball three nights a week and lifts weights regularly.
“I definitely have not lived a perfectly healthy lifestyle, but it’s not been horrible either,” Stemmle said. “I stay active – I mean, I got an Apple Watch in part to track my workouts. I saw myself as a healthy adult.”
After monitoring his elevated heart rate for an hour, Joey decided to head to a nearby emergency room. He was given an electrocardiogram (or EKG), which he was told was normal, and referred to a cardiologist for follow-up. That cardiologist had him wear a Holter monitor, a small portable device that records the heart’s rhythm for a few days. The results also came back normal.
“A month later, I was still having symptoms – I bent over to pick up groceries and my heart rate hit 150, things like that – so I followed up,” Stemmle said. “I was told ‘You’re probably just dehydrated’ – ‘Maybe your Claritin is causing this’ – ‘You’re just out of shape.’ And I’m sitting there saying, ‘But I play sports and I lift weights, three days a week.’ I’m not an Olympian, but I know what feels normal and what doesn’t.”
A Valentine’s Day gift ‘for myself’
Joey underwent further testing: an echocardiogram, a sleep study, thyroid testing, and a 14-day Holter monitor. It was this last test that finally revealed what he had been describing to his doctors all along: a two-hour window in which his heart rate was averaging 190.
Joey was first diagnosed with a condition known as supraventricular tachycardia – a common and treatable form of fast heartbeat that often arises in people under 40. However, Joey’s friend Sydney Greenberg, a nurse practitioner in Williamsburg, pushed him to get a second opinion at Pauley Heart Center.
“Sydney said, ‘If you’re having these electrical problems with your heart, you need to go see Dr. Ellenbogen and his team at Pauley Heart — he’s the best,’” Joey recalls. “I had to wait a few months to get an appointment, but when I met with Dr. Ellenbogen, he instantly said, ‘Oh, this is AFib, without a doubt.’”
Some providers will shove you out of their office so quickly and tell you you’re fine. But I know my body the most, I’ve lived with it the longest... I feel like I got put with the right team at Pauley Heart, because they never dismissed me.
Joey Stemmle, VCU Health patient
There are a variety of treatments for AFib, including medicines, non-surgical procedures, device implantation, and heart surgery. Today, one of the most common treatments is ablation, in which flexible catheters are inserted into blood vessels and directed to the heart, where doctors then use the catheter’s electrodes to both diagnose faulty electrical sites in the heart that cause the irregular or racing heartbeat of AFib, and then treat them through the application of radiofrequency energy. By delivering short pulses of energy to the faulty sites, the catheter creates scar tissue on the heart muscle that blocks the incorrect signaling.
Ellenbogen adjusted Joey’s medications which improved his symptoms in the short-term and scheduled him for an ablation.
"The VCU Health scheduler called and was like, ‘We can do the 14th, but that’s Valentine’s Day,’” Joey recalled. “I said, ‘Well, I’m single, so let’s do it.’ My ablation was my Valentine’s gift to myself!”
While he waited for his procedure, Joey borrowed his friend Miles Foden’s “fancier” Apple Watch – a model that offered EKG monitoring; he would then upload the EKG recordings to his VCU Health patient portal, and the Pauley team would review and respond to each.
“I can’t read EKG or any of that stuff, of course,” Joey said. “The Pauley Heart team would message back: ‘That one looks good - don’t worry about that one,’ or ‘What were you doing at this time?’ They were just so responsive, it was unbelievable. I would send a message, and I would get a response back, or an updated prescription, sometimes within minutes.”
Being able to get a quick and thoughtful response from his care team was something Joey had never experienced before. Other providers he’s work with, Joey says, sent conflicting information or would take 3 to 4 days to respond when he had a question. It was clear from the beginning of his time at VCU Health that a multidisciplinary team was working together to heal his heart.
After his ablation, Joey Stemmle hiked around Delta Lake in Grand Teton National Park in Wyoming. The lake sits at an elevation of 9,000 feet. (Contributed photo)
Becoming your own patient advocate to find the best care team
Valentine’s Day came and went quickly for Joey. He was surprised to find that only a week out from surgery, he was cleared to go back to lifting weights, playing sports, and living his active life.
“Now that I’ve had the ablation, I go out and play volleyball for two hours, and my max heart rate is 150, versus before the ablation, it would be 150 warming up,” Joey said. “It’s almost like I had forgotten what a normal heart rate feels like.”
And with his heart healthy and full of gratitude, Joey made an effort to thank everyone who helped him along the way by supplying a catered lunch to the entire electrophysiology team at the Pauley Heart Center.
Joey notes the most transformative part of his journey has been “learning that you have to be your own biggest advocate when it comes to your health. Some providers will shove you out of their office so quickly and tell you you’re fine. But I know my body the most, I’ve lived with it the longest.”
“I feel like I got put with the right team at Pauley Heart, because they never dismissed me,” he concluded. “They knew that something was wrong.”
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