Ablation

By Dr. Jim Ferguson
You might not be aware that your heart operates by electricity. No, not like an electric lamp or a hybrid car’s battery. But, nonetheless, the heart functions by electromagnetism, utilizing one of the four fundamental forces of the universe as defined by physics.

The heart is comprised of muscle, blood vessels and nerves. Blood vessels deliver oxygen and nutrients to muscle cells whose contraction is controlled by a pacemaker through a neural network. Actually, all cardiac cells have the inherent potential of acting as pacemakers. However, normally the primary pacer, sitting atop the upper atrial chambers of the heart, controls heart rate and rhythm.

Imagine a battery with trailing wires connected to your car’s engine. When the battery “fires,” an electrical signal is sent down the wires to spark the engine. The same happens when the cardiac pacemaker sends a signal down the neural wires of the heart causing the muscle to contract in a coordinated sequence. Problems occur when the pacemaker ages or becomes dysfunctional. This can necessitate implanting an artificial pacemaker to prevent pathologic slowing of the heart rate and syncope (passing out).

Problems can also occur when the conducting wires become “frayed” through disease, resulting in other pacemaker cells taking over. I’ve written about atrial fibrillation where hundreds of pacemaker cells in the upper atrial chambers all begin firing at once. As a result, the lower pumping chambers are bombarded with signals producing tachycardia (rapid heart rate). This can be treated with medications to slow the heart rate or used to restore normal rhythm. Frequently, cardiologists combine medication with cardioversion to treat atrial fibrillation, utilizing an electrical shock to the chest to restore normal rhythm. Lastly, an ablation procedure can be used to treat arrhythmias.

The word ablation derives from the Latin word ablatus and means “to remove or destroy, especially by cutting” or cauterizing. Cardiologists sometimes ablate a congenitally abnormal neural pathway that is causing PSVT or paroxysmal supraventricular tachycardia (sudden bouts of rapid heart rate). One of my patients with PSVT had her problem successfully treated with an ablation procedure several weeks ago. Atrial fibrillation is more difficult to treat with ablation because numerous areas must be treated/cauterized rather than one abnormal pathway.

While abnormal neural pathways can be removed by ablation, I find it necessary to also discount obvious disingenuous news reports and polls taken eighteen months before the 2020 election. Both have been proven biased, manipulative and unworthy of further consideration. A friend of mine said she has turned off the “news.” Intermittently, I have done so as well, especially when overt hatred reveals deceit and causes me visceral disgust. However, I feel it is my duty to stay informed, so I sacrificially listen and read and then use reason and common sense to discern the truth.

In last week’s essay, I discussed sacrificial listening as an alternative to the standard choices of fight, flight or surrender. Though Jesus had very harsh language for elitist reprobates of his day (see Matthew chapter 23), he nonetheless forgave them. He calls me to consider WWJD (what would Jesus do) and then interact sacrificially, even with those I consider misguided or lost to reason.

I’m not a psychiatrist, but I am often the first doctor a troubled person contacts. Consequently, I have emphasized the proper evaluation of depression and more serious psychiatric disorders with the medical students I teach. And though I have considerable experience treating mild to moderate depression, we all have “gifts differing” as Paul said, and we must recognize and respect our limitations.

Hatred is a destructive emotion and the antithesis of love. I can recognize/diagnose hatred, but I don’t have the wisdom, medication or words to overcome this terrible emotional disorder. I have respectfully tried to engage progressives and Democrats, but apparently many have written me off as “lost” to conversion. I realize it takes considerable effort to present a reasoned counter-thesis to what you consider as another’s mistaken or misguided thesis, but that’s the sacrificial alternative to the trilemma of fight, flight or surrender.

Several weeks ago I wrote about modern word usage in a column titled Verbicide. I no longer fish, but as a boy I learned that trolling was a fishing technique of trailing a lure behind a slowly moving boat. In the 21st century, trolling has been redefined as using provocative statements to lure someone into a response. Perhaps this is the ploy of AOC whose comments show she’s either incredibly stupid or just trolling like NY Governor Cuomo, who lit the World Trade Center in celebratory pink after extremely liberal abortion laws were passed.

Maybe leftists think I’m trolling them in this column. If that’s what you think, you’d be wrong, but you’ll never know without sacrificially engaging in reasoned and respectful consideration or debate (Hegelian dialectic).

So where do we go from here and what do we do in our strife torn country? I choose to embrace the perspective of the opening lines of A Tale of Two Cities, “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness.”

As a student of history, I can tell you that we do not have “the worst of times” despite our current problems. Truly hard times were the Civil War, the Depression and WWII. We Americans have grown accustomed to the affluence produced by capitalism which socialism/communism has never produced.

It is not reported, but much is being accomplished. I watched President Trump’s speech at his reelection rally, and was impressed by all the promises he has made and actually kept, including growing the economy, lowering unemployment, strengthening the military and improving America’s position in the world. The biggest remaining issue is the broken immigration system. Unfortunately, comprehensive immigration legislation will not be done before the 2020 election principally because Democrats hate Trump. However, the wall is slowly being built, and Mexico is now helping to stop illegal immigration.

I will watch the upcoming Democrat debates, and I challenge you to watch Trump’s reelection speech, if you missed it. Then, I ask you to make up your own mind rather than listen to what the experts say, especially since so many of them are ruled by hatred rather than reason. And I trust the common sense of the American people to “fly over the cuckoo’s nest” rather than following the tune of deranged pied pipers.

 

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