Skating on Thin Ice

Curtis AbfalterLacing up his skates and taking to the ice, Curtis and his teammates were ready for a competitive match between friends. Having been a busy day with chores and shoveling snow, what was to be a classic league hockey game soon turned into a fight for his life.

Curtis Abfalter remembers very little from the night of February 17, 2013. As a husband and father of four, he was used to the hustle of everyday life. Besides experiencing a slightly rapid heartbeat, Curtis felt ready for his game. It was shortly after he began skating that he collapsed on the ice, his friends rushing to his side. While waiting for the paramedics to arrive, his friends performed CPR and grabbed an automated external defibrillator (AED). The voice commands from the AED quickly walked them through the assessment and advised them to shock his heart. “If the device wasn’t there, I probably wouldn’t be here today,” says Curtis. When the paramedics arrived they cleared his airway and shocked his heart again. He was rushed to St. Alexius’ Emergency and Trauma and placed in a hypothermic drug-induced coma to help preserve brain function and allow time for his body to heal.

Dr. Nicholas Mahr, an interventional cardiologist with St. Alexius’ Heart & Lung Clinic, immediately performed a heart catheterization to identify a cause for his event. After a few days, Curtis was taken out of the drug induced coma. “I remember waking up and asking if I had been in a car accident,” says Curtis. “I then thought that I had a heart attack. I quickly learned that it was something entirely different.”

In Curtis’ case, a heart attack from diseased heart arteries was not the cause; however his heart was very weak. Curtis was diagnosed with nonischemic dilated cardiomyopathy (DCM), a condition in which the heart is not able to efficiently pump oxygen-rich blood because it is enlarged and weakened. “Curtis’ left ventricular ejection fraction, which is the amount of blood pumped out of the heart, was measured at 15 percent. The normal amount should be greater than 55 percent,” states Dr. Mahr.
Dr. Mahr explains, “Curtis’ weak heart caused ventricular tachycardia which is a fast but regular heart rhythm. This rhythm was responsible for his sudden cardiac death. This is different from a heart attack when the blood flow to the heart muscle is impaired.” Dilated cardiomyopathy (DCM) can be caused by various conditions including heart artery disease, infection, stress, drug induction, genetics or a virus. However, the majority of diagnoses have an unknown cause.

Curtis continued to have short episodes of ventricular tachycardia. Dr. Sanathana Murthy, a cardiac electrophysiologist with St. Alexius’ Heart & Lung Clinic, surgically implanted an automatic internal cardiac defibrillator (AICD) to protect against further episodes of sudden cardiac death. “The AICD device monitors the heart rhythm and detects if it is abnormal and needs correction,” states Murthy. “If the AICD senses that the rhythm is abnormal, it will deliver a shock to the heart to correct the problem.”
Curtis was discharged February 25, 2013, and after completing outpatient cardiac rehabilitation, he has made a full recovery. Although the exact cause of what triggered the condition might never be known, he finds relief knowing that no stone was left unturned. In-depth literature searches and conversations occurred between Dr. Mahr, Mayo Clinic and various specialists at St. Alexius about possible links between cardiomyopathy and Curtis’ past complex health history. It was decided the risk of invasive testing, which may have included a heart muscle biopsy, far outweighed the benefit. “It felt good knowing that St. Alexius exhausted all options to try to determine what caused this,” said Curtis.

His life has not been the same since that night, and if you ask him, it has changed for the better. “I have removed a lot of stress from my life…from changing careers to spending more time with my family.”

Although Curtis couldn’t have done anything to prevent this, he emphasizes the importance of healthy eating and getting annual physicals. “Know your cholesterol and blood pressure numbers and your family history with the risk of heart disease. My family is a lot closer now. They’ve realized what almost happened,” Curtis said. “Family was always special to us, but it’s extra special now.”