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Health Matters: Providence Saint John's Health Center | 9 he'd also need a Watchman, a tiny medical device inserted into the left atrial appendage, a small ear-shaped sac in the muscle wall of the top left chamber of the heart. The device works as a kind of filter to prevent blood clots that can lead to stroke, explains Dr. Doshi. If successful, it can eliminate the need for prescription blood thinners. "While ablation can fix atrial fibrillation, the Watchman device is revolutionary for the patient who cannot take blood thinners; and it can reduce the risk of stroke," says Dr. Doshi, who was one of the national principal investigators for the device when it was launched in 2017 and is now one of the nation's most experienced implanters of the device. Halff ended up undergoing three separate procedures. First was the ablation. During that procedure, Dr. Doshi noticed that Halff's mitral valve was leaking severely, so another Providence Saint John's team later inserted a clip to fix the valve. Halff's last procedure was the Watchman. "None of this was really that big of a deal," says Halff. "There was almost no pain or discomfort, and I went home the very same day as the procedure." ADVANCED IN TREATING ARRHYTHMIAS Dr. Doshi says that in addition to the procedures Halff had, he's also pleased with the improvements in pacemakers that are suitable for other types of patients. In particular, the Micra, a tiny pacemaker, is advancing arrhythmia care. Pacemakers treat patients with electrical blocks, a condition in which the electrical signals in the heart are fully or partially blocked, often due to heart conduction disease. Without treatment, the heart can beat dangerously slow. "This device was commercially released in just the last three years, and we've become a leader in implanting this new type of pacemaker," he says. "It's the size of a vitamin capsule and can be implanted without surgery." The Micra is inserted through a vein in an outpatient procedure. It does not require general anesthesia, and the pacemaker battery can last a full decade. All of the procedures are covered by Medicare. Dr. Doshi, who has published research in the top peer-reviewed academic journals, including The Journal of the American Medical Association, Lancet, Circulation, Journal of the American College of Cardiology and many others, says he gets enormous pleasure from this work. "There are very few things in medicine and cardiology which can be cured, and I feel very lucky to be a specialist in the field of electrophysiology, where we have the understanding and technology to cure many heart rhythm disorders. These disorders impact so many people." Afib alone affects roughly 5 to 7 million people in the United States. Fully one- third of the people who have it are unaware or aren't receiving treatment, he says. Symptoms can include a heart that races or flutters, as well as fatigue. A doctor may diagnose silent afib by conducting an electrocardiogram test. "Whether it's that you're not aware of the problem or it's that you don't want to treat it because you don't like a medication's side effects, you can be at high risk for a stroke," says Dr. Doshi, whose main aim is to raise awareness of the relatively simple procedures that are now available to resolve these conditions and potentially eliminate prescription medications. He says there are many patients who could both feel better and drastically reduce their risk of a potentially debilitating stroke and heart failure. For Halff, the small surgical fixes meant he could dispose of his medications. In fact, his blood pressure normalized along with his heartbeat, and Halff was actually able to eliminate the high-blood-pressure medication he was taking. He now takes only a daily over- the-counter aspirin to stave off coronary disease. In his mind, he was brought back to life. "There's just no comparison," says Halff, who praises not just the doctor 's skill but also his bedside manner. "He really looks out for his patients and takes the time to explain everything. Now I'm back to my normal self. In my opinion, Dr. Doshi saved my life." To learn more about cardiac arrhythmia and the treatment options, please attend a webinar hosted by Dr. Doshi on August 10 at 6:30 p.m. To register, call 888-HEALING (432-5464) or sign up at providence.org/ saintjohnsclasses. "There are very few things in medicine and cardiology which can be cured, and I feel very lucky to be a specialist in the field of electrophysiology, where we have the understanding and technology to cure many heart rhythm disorders."

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