The Challenge: An Abnormal Heart Rate
In 2008, Larissa Zeli was an undergraduate nursing student enjoying an evening at home with friends when her heart began to race so fast she couldn’t count the beats. Although she didn’t have pain or other symptoms, Larissa went to the emergency department, where she learned her heart rate was between 120 and 130 beats per minute, well above the normal 60 to 80 beats for most adults.
After an electrophysiology study, which assessed her heart’s rate and rhythm, Larissa’s doctor determined that she had a condition called inappropriate sinus tachycardia, or an abnormally high resting heart rate.
Larissa underwent two unsuccessful cardiac ablation procedures – which use heat or cold to safely destroy the tissue that causes an irregular heartbeat—and spent a few years trying different medicines to control her heart rate with little success. She continued to have symptoms and struggled with the fatigue and other side effects that came with her medicines. Larissa admits feeling discouraged, and wondering if she would ever get back to feeling well.
The Path to the UPMC Heart and Vascular Institute
After graduating college, Larissa worked as a nurse in the emergency department at Children’s Hospital of Pittsburgh of UPMC. One of her coworkers recommended that she see Samir Saba, MD, director of cardiac electrophysiology at the UPMC Heart and Vascular Institute.
Larissa underwent a third ablation procedure with Dr. Saba and his team at UPMC Presbyterian. She enjoyed a few years without symptoms, but while training for a half-marathon in 2015, Larissa noticed that her heart rate wouldn’t get as high as it should have during exercise.
The Solution: A Pacemaker
During a routine exam, Larissa talked with Dr. Saba about the trouble she’d had while training. He ordered a stress test, and no matter how hard Larissa exercised, her heart wouldn’t beat faster than about 120 beats per minute, well below her target rate.
Dr. Saba diagnosed Larissa with chronotropic incompetence, a condition in which the heart cannot beat faster during exercise. She needed a pacemaker, a small, implanted device that would stimulate her heart muscle to help it beat faster during activity.
Larissa underwent an implant procedure with Dr. Saba in February 2016. Three months later, she competed in Pittsburgh’s half-marathon, beating her previous race times despite having to walk a bit of the way.
Today, at 28, Larissa says she feels better than ever. She now works as a nurse practitioner in same-day surgery at Children’s Hospital and volunteers with the American Heart Association to raise awareness about heart problems in people of all ages.
Larissa's treatment and results may not be representative of similar cases.
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