Inova AFib Center Helps Patient Return to Triathlon Training and Racing

Dave Conover awoke on Sept. 23, 2022, with a start around 2:15 a.m. and immediately knew something was wrong with his heart. “It felt like there was a trout flopping around in my chest,” said Dave. “Everything just felt off.”

He’d experienced very brief instances of irregular or skipped heartbeats over the years, but this time it wasn’t going away. After about 15 minutes, he went to the nearest emergency room (ER). After several tests, he was sent home with a diagnosis: atrial fibrillation (AFib).

A new heart diagnosis

Dave was no stranger to cardiac treatment. In fact, he’d been receiving care for more than 15 years.

When Dave turned 39, he decided to increase his focus on physical fitness. With a swimming background, but after spending his whole life claiming he “wouldn’t even run for free beer,” he began training for a triathlon. It only took one race for him to be hooked.

In August 2005, he started experiencing chest pain, nausea and sweating shortly after completing a half-Ironman distance triathlon. He went to the ER, then followed up with his primary care doctor, who referred him to a cardiologist. During his visit with the cardiologist, Dave learned he had experienced a mild heart attack. The next day, he underwent stent placement at Inova. He then began ongoing conditioning and training through the cardiac rehabilitation program at Inova and was able to return to triathlon training and racing in early 2006.

After his AFib diagnosis in September 2022, Dave followed up with his cardiologist for more testing, including cardiac monitoring and a nuclear stress test. His medications were adjusted, and Dave started feeling much better. In fact, he ran a 5K with his sons and grandchildren only a week after his trip to the ER with AFib. His episodes of erratic heart rhythm seemed to have waned.

But after Dave caught COVID-19 in early October 2022, the AFib returned and would no longer stop on its own. Fortunately, Dave’s cardiology practice, Cardiac Care Associates – Fairfax, is also a clinical practice site for Inova Arrhythmia. His cardiologist referred him for specialized care with an Inova electrophysiologist.

“Having an electrophysiologist (EP) based within our practice offers patients a broader range of care,” according to Jonathan Yager, MD, Dave’s cardiologist. “It makes for a seamless transition to the EP physician and allows our patients to be seen quickly and in a collaborative setting.”

Inova AFib Center – effective, collaborative care 

The underlying conditions causing AFib are complex, and managing the condition often involves more than the medical procedures performed by electrophysiologists. Inova Arrhythmia follows a “center of excellence” model, where patients undergo a comprehensive risk factor assessment to customize their care and address all underlying risk factors contributing to their AFib.

This approach offers patients streamlined, team-based care that is personalized for individual needs. Depending on a patient’s risk factors, in addition to cardiology and electrophysiology, treatment may involve collaboration with specialists focused on weight loss, behavioral health coaching for managing stressa diagnostic evaluation by a sleep medicine physician or consultation with a clinical pharmacist.

“Based on a comprehensive screening, Dave didn’t have a need for additional risk factor services,” said electrophysiologist Brett Atwater, MD. “For those who need added support, we schedule them at the Inova AFib Center for a streamlined appointment with the relevant specialists in one location. Often, AFib patients are advised to set up multiple follow-up appointments with other specialists to address underlying risk factors. At our center, we bring the specialists to them. That integrates their care in a more timely and convenient manner.”

At Dave’s appointment, Dr. Atwater explained more about what AFib is and why it occurs. He reviewed all of Dave’s treatment options and gave his recommendations. “Dr. Atwater was very thorough and did a great job explaining all the research from the last several years,” shared Dave. Dave also took advantage of the online resources available through the Inova AFib Center website, which helped him learn more about AFib as he prepared for his initial visit with Dr. Atwater.

Dave and Dr. Atwater decided on catheter ablation, a procedure that strategically and safely destroys (ablates) the small area of heart tissue causing the irregular rhythm. “I felt totally informed and confident on the day of the procedure,” said Dave. “From start to finish, every person involved with my care was on the same page.” Within hours of the procedure, Dave’s AFib symptoms disappeared.

Individualized treatment

Within two weeks of his procedure, Dave was itching to get back to his usual activity levels. As soon as he was cleared to exercise, he started working on regaining fitness with his triathlon coach. Two months to the day after the ablation, Dave completed a sprint triathlon. Four months out, he completed two aquabike races over one weekend and continues to train at his pre-AFib levels in preparation for four more triathlons this season.

“Dave is an uncommon person with a very common problem,” according to Dr. Atwater. “While many of our patients experience a reduction in exercise capacity or even fatigue at rest, Dave’s excellent physical conditioning meant he could still run, swim and bike despite his AFib. His story highlights a truth about AFib: Everyone experiences it a little differently. At the Inova AFib Center, we dig deep to understand how AFib has impacted our patients physically, medically and mentally. This allows us to develop an individualized treatment plan that will meet our patient’s needs and goals.”

Watch Dave’s story on NBC Washington

Visit inova.org/afib to learn more about the Inova AFib Center.