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Speaking from the Heart

Former Insurance Executive's Arrythmia Treatment Leaves Him Feeling "Simply Grand"

Dan Toran with
grandchildren Ada and Jacob

The thought of lecturing in front of large groups of corporate executives would cause most of our hearts to pound. For Daniel Toran, former president and chief operating officer of The Penn Mutual Life Insurance Company, public presentations came easy. His heart flip-flopped for another reason.

Dan began suffering from atrial fibrillation, or irregular heartbeat, approximately five years ago. If left untreated, "a-fib" can leave patients weak and incapacitated, or at serious risk of stroke, heart attack, or heart failure.

The now retired business executive believes his arrhythmia developed after a serious bout with sleep apnea (snoring and gaps in breathing that can wake an individual hundreds of times a night). "I could actually feel my heart going into a-fib. I would get extremely weak," Dan explains. He consulted his Abington Memorial Hospital cardiologist, who then referred him to Richard Borge, M.D., electrophysiologist and medical director of Abington's Heart Rhythm Center. Dr. Borge worked with him to find the right combination of medications to prevent the occurrences.

The Heart Rhythm Center is dedicated to providing the most advanced diagnosis and treatment. It is well known for its a-fib advancements, with area physicians sending their most complex arrhythmia patients to Abington for additional options. Those alternatives, provided in a minimally invasive way, would prove to be the answer Dan needed.

Originally, the medication worked. Dan would experience only an episode every month or two. "Most of the time it was self-correcting," he adds. "I'd just take a little extra medication and rest for awhile.

"I coped with it, even as it began to happen a bit more frequently," he recalls. The executive charged ahead with running a company, traveling, and serving on Abington Memorial Hospital's Board.

About two years ago, the episodes increased, until Dan was slipping into a-fib three or four times a week. It was taking a toll at work, especially with flying cross-country, and on his lifestyle. He and Dr. Borge discussed another alternative.

Dr. Borge notes, "We always focus on the most conservative therapies first. However, medications may lose their effectiveness over time, leaving the patient with increasing incidences of atrial fibrillation. The condition can be extremely debilitating and hard to control."

Enter Mauricio Garrido, M.D., cardiothoracic surgeon and surgical director of the Heart Rhythm Center. Dr. Garrido began collaborating with Dr. Borge around the time Dan's heart was skipping almost daily.

Dr. Garrido performed a minimally invasive a-fib epicardial ablation procedure on Dan in February 2008. It's essentially surgery without the "open-heart" part. Access to the heart is achieved through small incisions on the patient's chest. Using minimally invasive techniques, a bendable probe is inserted through one of the incisions to encircle and create a therapeutic scar around the pulmonary veins. The scar tissue that is created prohibits the erratic electrical activity that causes atrial fibrillation from escaping the pulmonary veins.

Dr. Garrido explains, "Patients with a-fib often have overactive nerves in the regions surrounding the pulmonary veins. We map this grouping of nerves, called ganglia, in order to eliminate them through cauterization (heat). In addition, an area of the heart where blood clots form, known as the left atrial appendage, is removed in most patients."

The minimally invasive procedure means less recovery time, with patients ready to leave the hospital in a few days instead of seven or more with traditional open-heart surgery.

The wonder of it all is not lost on Dan Toran. "I really just had moderate physical therapy and was back to doing regular things in a couple of months," he says. "And here we are, 18 months later. I've never had another a-fib event."

He has experienced a few other life-changing moments, all for the better. Dan decided to retire at 61 and move with his wife, Amy, from Flourtown to Falls Church, Virginia.

The lovely enclave just outside of Washington, D.C. features the one thing they can't do without - their grandchildren, 4 ½ -year-old twins and an 18-month old. "Most of our family is here," Dan adds, "including my 89-year-old mother.

"Thanks to Dr. Borge, Dr. Garrido and the Heart Rhythm Center, I'm just another miracle success story from Abington Memorial Hospital," Dan concludes.

There's no doubt the sentiment is heartfelt.

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