Rare Surgery for Heart Condition Performed for the First Time at Methodist University Hospital

Published On 08/23/2013

Patient Ernestine and Dr. Kabra at Methodist University Hospital

Photo: Ernestine Jones is grateful for Dr. Rajesh Kabra's dedication. He  found an uncommon surgical procedure that was the perfect solution for her cardiac issue. 

Ernestine Jones is extremely thankful for her physician Rajesh Kabra, M.D., medical director of electrophysiology and ablation services for Methodist University Hospital and assistant professor of medicine at the University of Tennessee Health Science Center. Dr. Kabra specializes in cardiac pacing and arrhythmia issues.

Jones appreciates the time he invested to find the right treatment option that met her needs and very possibly saved her life. In rare cases an ICD can be implanted under the skin in the lower abdomen with the leads using the iliac vein in the groin to gain access to the heart. This surgical procedure had never been done at Methodist University Hospital.

“He didn’t give up on me,” says Ernestine Jones.

Lupus attacked her heart and kidneys in 2012, sending her to dialysis three times a week. In addition to this, she went into cardiac arrest where her heart stopped beating. Jones was left in a coma for two days. Dr. Kabra diagnosed Jones with ventricular fibrillation a heart rhythm which results in the heart beating so rapidly causing the heart to stop circulating blood throughout the body.

She needed an implantable cardioverter defibrillator. However, there was a problem. Her catheter for dialysis had clogged the vein that the leads from the defibrillator needed to gain access to her heart.

“Typically, an ICD is implanted above the heart,” said Dr. Kabra. “In Ernestine’s case, the ICD couldn’t be planted above the heart, so I researched other options that might help.”

In the meantime, Dr. Kabra ordered Jones a LifeVest, a wearable defibrillator for patients who are at risk of sudden cardiac arrest. LifeVest protects patients from cardiac arrest while doctors determine what course of action is best.

“It was very important to me to find an option that would work for Ernestine,” said Dr. Kabra. “When I learned that an ICD could be implanted below the heart I collaborated with Dr. Eva Proctor, a cardiothoracic surgeon with The CardioVascular Center. I placed an ICD lead from the groin into the heart, while Dr. Proctor created a pocket under the skin of the abdomen to implant the ICD. These complicated and innovative procedures require collaborative efforts from multiple specialties and we are fortunate to have such an environment at Methodist University Hospital.”

Dr. Proctor says the procedure Jones needed was rather rare, but it was a procedure Jones couldn’t live without.

“It was very important for Ernestine to have the ICD because this device will provide some safety for her against premature death from ventricular arrhythmia,” said Dr. Proctor.

Jones says she feels 100% better. This former hair stylist is looking forward to completing the course she needs to teach hairstyling.