The people of San Antonio recognize a hero when they see one. They proudly wave Spurs banners and cheer their champions on at every game. What many in the Alamo City don’t know is that their city is also host to many unsung heroes who break other records; these heroes make it possible for hearts to continue beating another day and for people to live years longer than they otherwise might.
Two of these local heroes are electrophysiologist cardiologists Dr. Javier Roman-Gonzalez and Dr. Charles Machell. These two individuals are forging ahead with new technologies and discoveries that can help prolong lives.
Electrophysiology deals with the electrical pulses of the heart. Device implants and catheter ablation are the two basic procedures of electrophysiology. The most common devices used in this field are the pacemaker and defibrillator.
Catheter ablation is an advanced technique that utilizes radio-frequency energy from tiny electrodes. These electrodes then cauterize tiny fibers of heart muscle tissue where abnormal beats originate. This process restores the heart muscle to a normal heart rate and rhythm about 80 to 90 percent of the time. Catheter ablation has replaced open-heart procedures for the elimination of most arrhythmias.
Cardiac electrophysiology is a new field—officially only a subspecialty since 1992. Very few cardiologists are also electrophysiologists, and that is why patients will travel such long distances to find a good one.
Roman-Gonzalez and Machell have vast experience in ablation of complex arrhythmias like atrial fibrillation, ventricular tachycardias, pediatric ablations and laser LED extraction.
“The progress with electrophysiology and cardiology in the last 10 years is no less than amazing,” Machell says. “In the ’80s it was all open-heart surgery. Today it is just a needle puncture procedure with a catheter; and a few hours later the patient is home.”
Born and raised in Puerto Rico, Roman-Gonzalez came from a happy home. His eight siblings have become successful teachers, lawyers and nurses; one of them even became a judge. His parents stressed education; his mother, an OR nurse, especially nurtured Roman-Gonzalez’s early interest in medicine and surgery.
He trained under Dr. Douglas Packer at the famous Mayo Clinic for two years before coming to San Antonio. From 2001 to 2006, he worked as the director of electrophysiology at Wilford Hall while serving in the U.S. Air Force.
Roman-Gonzalez made history by performing the first atrial fibrillation ablation procedure in San Antonio and South Texas at Wilford Hall during that time.
Atrial fibrillation is considered the Mount Everest of the electrophysiology field, and offers a significant chance of cure and improvement in quality of life. He is known throughout the country for his expertise in this procedure.
“Javier is a mover and a shaker who makes things happen, an exceptional person,” said Machell of Roman-Gonzalez. “He creates his opportunities.”
Raised in the midst of the NASA space program in Houston, Machell’s greatest mentor was his father, who was a NASA engineer program director. His father, who trained as an aeronautics engineer, came in at the inception of the space program.
Machell, also a pioneer in his field, became fascinated with the new electrophysiology specialty while studying to be a cardiologist. He completed his post-graduate work in Albuquerque, where he lived for 20 years. The University of New Mexico, where Machell trained, was one of about 20 universities across the nation involved in research and new developments in catheter ablation in the early 1990s.
The University of Oklahoma (OU) was the first in the country to get involved in research and discovery in electrophysiology. Machell worked regularly with one of the key players at OU; he was involved with a number of presentations on electrophysiology across the country as new information became available.
Machell is an expert in arrhythmia ablation procedures and has special interests and skills in ventricular tachycardia ablation. Pediatric work is also one of his specialties, and he works regularly at the Methodist Children’s Hospital.
“It’s gratifying to help a 6-year-old patient whose life would be threatened or would have lifelong symptoms and to able to fix them,” he says.
Machell volunteered and started a program devoted to the screening of young athletes’ hearts at his daughter’s school, St. Mary’s Hall. He says he started the program because he heard so many stories about young athletes dropping dead on the field or court every year. The screening is a simple procedure that can save lives; Machell is trying to push for legislation to make this screening a statewide protocol, as it is in some other states.
“The advances in the last 20 years in the field of electrophysiology and cardiology have been unbelievable,” Machell says. “Most of these are related to technology developments that allow us to do the electrophysiological procedures.” These procedures are becoming less and less invasive.
Roman-Gonzalez says that robotics is the next step. “Robotics ablation will be available in San Antonio in the next 18 months, and this will improve the safety of electrophysiology.” The procedure will also be more precise and take less time.
In arrhythmia ablation procedures, doctors and patients are exposed to small amounts of radiation. The doctors wear 30 to 35 pounds of lead for protection against radiation while performing procedures. Radiation exposure will be significantly reduced for patients and physicians with the robotics equipment. This equipment allows catheter manipulation to be done by computer using the physician’s input for direction.
With the exceptional improvements in cardiology and electrophysiology in recent years, as well as with these medical marvels performing these procedures in San Antonio, local patients no longer need to travel many miles to find the help they need.
So you see, the Alamo City has other unsung heroes—not only its Spurs. These doctors improve and save lives each day. They, too, have earned hero status and give the people of this city one more reason to be proud to live in San Antonio.
For more information on the South Texas Cardiovascular Consultants please visit www.heartdoctors.net.
