Tangela Huggins was working a shift in the emergency room at Good Shepherd Medical Center in Hermiston when her heart began skipping beats and she couldn't catch her breath.
She knew the situation was serious -- she's a nurse with experience in cardiac care, and she's also been dealing with her own heart problems for years. She developed a condition called postpartum cardiomyopathy after her son was born in 2006, and that led to congestive heart failure.
The palpitations during her shift in February sent her to Kadlec Regional Medical Center in Richland, where she ended up in the care of Dr. James Kneller, an electrophysiology cardiologist.
A recent transplant from Spokane, he treats problems with the heart's electrical system.
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That work can include implanting devices such as defibrillators, which shock the heart back into a normal rhythm. Last month, Huggins received one of those devices -- a new kind of implantable defibrillator that's less invasive than traditional models. It was the first time that particular device was implanted in the Tri-Cities.
The procedure took about an hour, and Huggins was able to leave Kadlec the next day.
She's now preparing to return to work -- and she's feeling grateful Kneller is practicing in the area. "I breathed a sigh of relief when I found out there was a (local) doctor to handle these rhythm problems," she told the Herald.
Kneller joined Kadlec earlier this year. He came to the Richland health system from Deaconess Hospital in Spokane, where he was medical director for electrophysiology. While in Spokane, he treated many Tri-City patients who made the trip because of a lack of local options, he said.
Making the move to Kadlec seemed like a good fit, he said. Kadlec has invested about $1 million in the electrophysiology program, including new equipment and additional staff. It's the first local program of its kind, Kadlec officials said.
Kneller is keeping a busy schedule.
Along with seeing patients in a clinic setting and implanting devices such as Huggins' defibrillator, he also performs procedures that cure fast and/or irregular heart rhythms through a process known as ablation. In that procedure, a catheter is threaded through a vein to the heart and uses heat energy to disrupt the electrical properties of some of the tissue to fix the abnormal rhythm.
Kneller performs as many as 10 ablations a week, including at least two for atrial fibrillation, a common heart rhythm problem that increases the risk of strokes, heart attacks and other issues. Atrial fibrillation ablation is especially complex because of the location of the heart chamber where most of the work is done.
Kneller performed an ablation procedure on a patient with atrial fibrillation early last week. He appeared relaxed but focused as he worked with the catheter and led a team of electrophysiology technologists and others at the patient's side and behind computer screens in the control room.
It went well, Kneller said later.
So did Huggins' procedure the week before.
The device she received -- an implantable defibrillator made by Boston Scientific, called S-ICD -- doesn't involve placing wires through blood vessels into the heart, unlike traditional implantable defibrillators.
That makes it a particularly good option for younger patients, like Huggins, who'll have the device in place for years, Kneller said.
About 1 1/2 weeks before Huggins' procedure, Kneller implanted a new kind of cardiac monitor made by Medtronic in a different patient. It was the first implant of that device in the state.
Rand Wortman, Kadlec Health System president and chief executive officer, noted Kadlec has offered heart services for years, from general cardiology to open heart surgery.
"Offering an electrophysiology program is the final piece of a comprehensive cardiac program for Kadlec," he said. "This is another service that allows people to stay in town" for their care.
He said Kneller and his electrophysiology offerings have been well received. Kneller said he wants the community to know about the new services and that his team is welcoming patients. They can ask for a referral from their physician or call Kadlec Inland Cardiology directly, he said.
Huggins, who spent five years as a cardiac nurse in Portland before coming to Hermiston, said she sees a need for local electrophysiology services.
"A lot of people have rhythm problems. A lot of people get these (kinds of cardiac) devices. It's not just getting the device, you have to get it checked regularly," she said. "If (patients) are being treated by someone far away -- I can't imagine having to drive to Spokane or Portland all the time to have it checked. It's nice they have that service.
"It's a sigh of relief for me."
-- Kadlec Inland Cardiology is at 942-3272.
-- Sara Schilling: 582-1529; firstname.lastname@example.org; Twitter: @saraTCHerald