Shockwave Technology Keeps Heart Care Safe and Efficient

In March of 2021, Ashley Martin suffered cardiac arrest, which kills about 90% of people when it happens outside of a hospital. Thankfully, she was already at Wellstar Kennestone Regional Medical Center receiving the compassionate care she’d been seeking to address a long list of symptoms.

Everything began at a hectic time in Ashley’s life. She was 30 and had just gotten engaged. Wedding planning had started with the help of her fiancé and their two young boys. The hope had been to have the wedding toward the end of 2021. But the unexpected happened.

“I was always healthy,” she said. “I grew up playing sports. I was a runner. I used to get headaches, but that was the extent of my medical history.”

Finding the right care when there is more than one symptom

Symptoms of what would ultimately be diagnosed as Guillain-Barré syndrome began in February of 2021. This rare neurological disorder causes the body’s immune system to attack the nerves. 

Ashley started experiencing tingling in the tips of her hands and feet, which moved up her legs and arms as days passed. When intermittent numbness became a symptom, Ashley went to a hospital near her Peachtree City home. A clean CT and MRI meant she went home with plans to see a rheumatologist.

As she waited for her first appointment, she started feeling numbness in her feet.

“At one point, I took a step down the stairs and went tumbling down to the concrete floor,” Ashley said. 

On another trip to the hospital near her home, Ashley was diagnosed with Guillain-Barré syndrome, but treatment was unsuccessful. The numbness continued, spreading to her face. She began using a walker and, soon after, a wheelchair.

“The paralysis had moved to my abdomen,” Ashley said. “I went to sleep one night and woke up abruptly gasping for air.”

Compassionate medical care at a pivotal point

 Later that night, an ambulance brought Ashley to Wellstar Kennestone, where she would finally get the specialized neuro care she desperately needed. She was admitted to the Neurocritical Care unit, staffed by physicians, nurses and a medical team with specialized training in neurological conditions.

Upon arrival, she underwent respiratory failure due to paralysis spreading to her diaphragm. She was stabilized, but shortly after that, she experienced sudden cardiac arrest — the abrupt loss of heart function that stops blood flow to the body.

After a critical care nurse administered CPR, Ashley’s heart started beating again. Life support medications were given to keep her heart pumping.

“The neuro ICU nurses and doctors saved my life,” she said.

Later, her attending neurologist explained that the stress of her nervous system and immune system fighting, paired with respiratory failure, caused such high stress that she had a cardiac arrest.

Wellstar Health System announced today that The Joint Commission recognized Wellstar North Fulton Medical Center as a Comprehensive Stroke Center, the most demanding stroke certification recognizing hospitals that have specific abilities to receive and treat the most complex stroke cases. With two of the eight Comprehensive Stroke Centers in Georgia, Wellstar Health System now offers stroke patients greater access to the highest level of stroke and aneurysm care. Wellstar Kennestone Regional Medical Center is also Joint Commission certified as a Comprehensive Stroke Center.

“For years, we have provided world-class stroke care for each and every patient when they need it most. This designation represents how hard we have worked to provide the very best quality care for patients in North Fulton County and across Georgia. We’re proud that our work and subsequent positive patient outcomes are being recognized,” said Dr. Michael Mendoza, medical director of the Stroke Program at Wellstar North Fulton.

Wellstar North Fulton’s certification allows more Georgians to have access to the most advance diagnostics and treatments for cerebrovascular disease such as stroke. This is important because Georgia is located in the Stroke Belt, which is comprised of 11 states in the Southeast where the associated mortality rate for stroke patients is 10 percent above the national average.

At Wellstar North Fulton and Wellstar Kennestone, patients have access to advanced diagnostics and therapies to care for even the most complicated strokes faster and more effectively. These include:

• Neuro Intensive Care Units –  A multidisciplinary team of physicians and nurses who specialize in neurocritical care.
• Minimally-invasive treatment – Wellstar is one of only four programs in the state that offer neuroendovascular treatment, such as minimally-invasive clot retrieval, patients can be provided with a much less invasive treatment technique.
• Cutting-edge imaging – Neurointerventional biplane imaging shows detailed, 3D views of blood vessels in the brain. This allows neurosurgeons to flip neuroendovascular cases to an open neurosurgical case when needed.
• Pioneering technology – Wellstar North Fulton was among the first hospitals in the country to use the groundbreaking Artemis Neuro Evacuation device to treat brain bleeds, a condition that was nearly impossible to treat in the past.
• Around-the-clock care – Artificial intelligence such as VizAi allows quicker identification of patients who are candidates for thrombectomy and organizes care in a connected system by quicker response to identify and provide care as quickly as possible.

“Our team of neurosurgeons, neurocritical care physicians, neuroradiologists, advanced practice practitioners and nurses work together to perform world-class thrombectomies, aneurysm treatments, carotid surgeries and cerebral bypass procedures so that patients can regain their best quality of life. Additionally, our dedicated hybrid neurovascular suite is equipped with innovative bi-plane technology. This allows neurosurgeons to view highly detailed images of brain vessels, so we as a team can customize treatments in real time,” said Dr. Arthur Grigorian, neurosurgeon, Wellstar North Fulton.

“When you have a stroke, every second counts. Getting fast, expert stroke care can mean the difference between life, death, or lasting brain damage. We are proud to receive this prestigious certification at Wellstar North Fulton, informing the surrounding community that they don’t have to go far to receive the best treatment possible. We will continue to work hard to provide an interdisciplinary, innovative, and compassionate approach to safe and quality comprehensive stroke care to all the communities we serve,” said Jon-Paul Croom, president, Wellstar North Fulton and senior vice president, Wellstar Health System.

Wellstar is a leading provider of stroke and aneurysm services in Georgia and performs one of the highest numbers of thrombectomy and aneurysm treatments in the country. The Joint Commission is a United States-based nonprofit organization that accredits more than 22,000 healthcare organizations and programs.

There aren’t many people out there who can say they survived cardiac arrest at 30. Kevin Miskewicz can.

According to the American Heart Association, more than 90% of people who experience an out-of-hospital cardiac arrest die. Those who survive often have permanent neurological disabilities. But Kevin’s story has an incredibly fortunate ending, thanks to the highly coordinated work of his medical experts at Wellstar.

Recovering from cardiac arrest is something Kevin will never forget. It lives forever as a piece of his health history — one that includes a dedicated healthcare team — and his wife, who was the first to save his life.

CPR to the rescue

Kevin woke up on Labor Day 2017 at 5:30 a.m. to take the dog out. Pausing to adjust the thermostat as he came in, he fell, knocking over a lamp.

He was in cardiac arrest.

With no symptoms and no known pre-existing condition, this was unexpected, but that didn’t stop his wife, Andrea, from jumping into action.

“If it weren’t for me knocking over a lamp when I passed out,” said Kevin, “she would have never woken up and saved my life.”

In addition to calling 911 and unlocking the door for the paramedics, Andrea performed CPR for 10 minutes.

“Kevin’s wife doing good CPR was critical,” said Dr. Arthur Reitman, the interventional cardiologist who was a vital part of Kevin’s treatment team at Wellstar Kennestone Regional Medical Center. “More than five minutes of poor blood flow to the brain can result in permanent irreparable injury from which a patient is unable to recover.”

Coordinating multidisciplinary care to save a life

When paramedics arrived at Kevin’s home, he had no pulse and was not breathing. As the paramedics performed their lifesaving work, he technically died two times.

The ambulance took him to Wellstar North Fulton Medical Center, where he was initially assessed and treated by Dr. David Jacoboff. The interventional cardiologist implanted an intra-aortic balloon pump to stabilize him. Then, he transferred Kevin to Wellstar Kennestone Regional Medical Center for highly specialized heart care.

When Kevin arrived at Kennestone by helicopter, his heart function wasn’t strong enough to support his body. Dr. Reitman and a team of doctors including a cardiologist, a pulmonologist and critical care doctors worked in tandem to put Kevin on an advanced life support system called veno-arterial extracorporeal membrane oxygenation. Better known as VA-ECMO, it took the heart “offline” so it could heal. The technology removed unoxygenated blood from his body, oxygenated it and pumped it back in for the next three days.

“Very few places in the state — only four or five hospitals — have the technology and specialized training to put a patient on ECMO,” Dr. Reitman explained.