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Michael
Atrial Fibrillation Patient | Heart & Vascular

Michael Munaco, atrial fibrillation patient, smiles at the camera

In 2012, Michael Munaco was enjoying a fun but demanding career as a freelance sports cameraman, regularly working long and intense hours to keep up with his full schedule. Eventually, the fast pace caught up with him and he started feeling his heart race and experiencing shortness of breath.

“I couldn’t catch my breath walking up stairs; walking anywhere. I kind of figured something was wrong, but I thought it would go away,” he said. When he finally visited a doctor, Michael was diagnosed with atrial fibrillation.

Atrial fibrillation, a common type of irregular heart rhythm, produces different symptoms among patients who experience it. Causes vary as well, with potential triggers including hypertension, diabetes and sleep apnea.

After repeatedly trying a number of treatments, nothing seemed to work for more than a couple of months.

Michael and his wife began researching doctors again, looking for someone who could provide Michael with long-term relief from his symptoms. They found Phillip Cuculich, MD, a Washington University cardiac electrophysiologist at Barnes-Jewish Hospital—one of the nation’s leading heart rhythm specialists.

“When I met Michael, he had atrial fibrillation for the better part of a decade, really. He was only in his fifties, and it was clearly affecting his quality of life and getting in the way of him enjoying what he did for a living,” Dr. Cuculich explained. “He went through the standard treatments of trying medicines, undergoing cardioversions and even underwent a procedure that creates safe and effective scars on the heart to stop abnormal electrical impulses from traveling through it, called a catheter ablation.”

Dr. Cuculich presented Michael with an innovative and noninvasive treatment option called cardiac mapping. Created by Washington University biomedical engineering professor, Dr. Yoram Rudy, it was tested and developed at Barnes-Jewish Hospital. The process monitors the patient’s heart using a vest equipped with electrodes on the front and back.

“So as a patient wears the vest, we wait for the arrhythmia and we are able to capture it and know exactly where it is coming from,” Cuculich said. “This is the way to tailor and personalize treatment for patients with heart rhythm problems.” Ten years later, Washington University and Barnes-Jewish Hospital is one of just a dozen medical centers nationwide utilizing this cardiac mapping system.

Michael agreed to try the catheter ablation again, this time with Dr. Cuculich guiding the process, assisted by cardiac mapping.

“We went directly to an area that the vest had suggested was driving his atrial fibrillation. Within the area of mapping and ablating, the a-fib had stopped. It really was a beautiful thing to see.” Dr. Cuculich shared. “Of course we went on and tested to see if we could get his a-fib to start up again, and indeed, it did not.”

Within weeks of follow-up testing, it was clear that the atrial fibrillation Michael had experienced for years was finally gone.

“When you are in a-fib for so long, it becomes a way of life and it really wears on you. So it is quite a relief to have a regular heartbeat. I am off the medication, which means I have more energy.” Michael shared. “We love to go camping and canoeing. And I am able to go with my wife and my dog for longer walks. I am doing the things I didn’t normally do—it has changed my life around.”


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