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HEART Insight:
doi: 10.1097/01.HEARTI.0000334386.25437.de
Features: Cover Story

Sittin' On Top Of The World

Haupt, Jennifer

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Abstract

Climb Every Mountain – How One Woman Conquered Congenital Heart Disease

Alison Levine, 42, is no stranger to taking on steep challenges in her life. In the last 10 years, she traveled to seven continents to scale the world's highest peaks and skied across the Arctic Circle to the North Pole.

She has also made history: Last January, she became the first American to ski across a remote 600-mile Antarctic route to the South Pole, and in 2002, she led the first American Women's Everest Expedition.

But before accomplishing any of these feats of derring-do, Alison had to overcome a life-threatening congenital heart condition that went undiagnosed for the first 17 years of her life.

“Even as a young child, I'd have dizzy spells and times when my heartbeat would speed up noticeably,” recalls Alison, who grew up in Phoenix with one older brother and one younger brother. “I'd mention it to my parents once in a while, but they didn't realize how serious it was and never took me to see a doctor. They'd just chalk it up to being nervous about a history test or a student council speech.”

Alison's symptoms became more pronounced as she entered her teens, and the episodes of rapid and irregular heartbeat became increasingly frequent. On a ski trip with friends when she was 17 years old, her heart began racing so rapidly, she passed out. Her friends drove her to the nearest emergency room, where an electrocardiogram (EKG) revealed she had a serious heart abnormality.

In a normal heart, electrical signals move through the heart along one path, the atrioventricular (or AV) node. The heart beats — that is, contracts and expands — as electrical signals spread through the walls of the atria (the upper chambers) then move to the walls of the ventricles (the lower chambers). If the timing of the electrical signals is off, arrythmia — rapid and erratic heart rhythms — may occur.

In Alison's heart, there was an abnormal electrical pathway between the atria and the ventricles that created a second circuit for electrical signals, allowing them to bypass the normal switching station where the signals are slowed. So the signals zoomed from the upper chambers to the lower chambers, causing the heart to beat unusually quickly. The electrical signals can travel down and back up these raceways incessantly. This particular type of congenital heart defect is known as Wolff-Parkinson-White (WPW) syndrome. Left untreated, WPW can lead to fainting and loss of consciousness. In some people, atrial fibrillation — a type of arrhythmia characterized by rapid and erratic activity in the upper chambers — can result. This is a potentially lethal development in WPW patients, which must be prevented.

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IF AT FIRST YOU DON'T SUCCEED

“I was more relieved than worried when I learned that there was something wrong that could actually be treated,” says Alison, who saw a cardiologist the very next day. A few weeks later, she was in the hospital for what was then an exciting new alternative to open heart surgery to eliminate the extra pathway — radiofrequency catheter ablation. In this procedure, a catheter (a fancy name for a tube) equipped with an energy-emitting probe is inserted into a large blood vessel through a small cut near the groin and guided to the heart. When the tip of the catheter reaches its target — in Alison's case, that troublesome extra pathway — it's zapped with radiofrequency energy and destroyed.

Unfortunately, the procedure was unsuccessful, and Alison was given medication to stabilize her heart rhythm. Though she experienced such side effects as nausea, headache and ringing in her ears (tinnitus), she didn't let that stop her from setting the highest goals for herself and going after them full-bore.

“I've never been one to dwell on the negative,” says Alison, who is an avid skier, hiker and runner. “I've always been very active, both mentally and physically, and I wasn't going to let this illness get me down.”

After getting a bachelor's degree in social and behavioral science from the University of Arizona, Alison moved to San Francisco where she spent 11 years in the pharmaceutical and medical devices industry. When she turned 30 years old in 1996, she decided to try the ablation procedure again. This time, she looked up a doctor at the University of California San Francisco her cardiologist had mentioned when she was first diagnosed, who had a lot of experience with WPW. “I figured in the past 13 years there had to be some kind of progress being made [in the ablation procedure].”

Luckily, Alison was right. A more flexible catheter was being used, allowing doctors to deliver the radiofrequency energy with greater precision than before, and the success rate had increased to 85–95 percent. The second time was the charm for Alison; she was even able to stop taking her medication.

After an overnight stay at the hospital, Alison was amazed by how quickly her symptoms were alleviated. Suddenly, she didn't have to worry about the possibility of passing out when she bent down to tie her shoes — or just standing still.

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“[T]his is one of the most remarkable technology advances in heart disease,” says Melvin Scheinman, M.D., the cardiologist and electrophysiologist who performed the second procedure on Alison. “We usually alleviate the symptoms of heart conditions with pills and surgery, but this is a real cure. The real beauty is that it's a noninvasive outpatient procedure as opposed to open heart surgery.”

“I had this incredible new lease on life,” said Alison. “Not only did I no longer have a heart condition, but I didn't have to deal with the side effects of taking medication. I felt healthier than I ever had and wanted to take full advantage of my new improved body — really test it to the limit and see just how far I could go.”

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REACHING FOR THE HEAVENS

Eighteen months after the corrective procedure, during the summer before she started graduate school at Duke University in Durham, NC, Alison wanted to test her freedom from WPW. She went on a “last hurrah” vacation with friends to Europe and Africa and got hooked on heights — first, climbing the slopes of the Swiss Alps and then climbing to the summit of Mount Kilamanjaro in Kenya using gear borrowed from a friend. “[T]he top of Kilimanjaro, which juts out of the African savannah, was amazing — so beautiful and peaceful,” says Alison.

“[D]uring business school, I used every break I had from classes to go climb a different mountain in a different part of the world. I never intended to climb the seven summits. This was never a plan — more of an accident.” By the time Allison finished graduate school in 2000, she had reached the summits of five of the seven highest mountains in the world: Kilimanjaro, Elbrus in Russia, Cerro Aconcagua in Argentina, Carstensz Pyramid in Indonesia and McKinley in Alaska.

At age 34, she changed gears and went from climbing mountains to climbing the corporate ladder at Goldman Sachs, a prestigious Wall Street investment banking powerhouse. She was working 80 hours a week, but never lost sight of her goal to tackle those last two mountains: Vinson Massif in Antarctica and Everest in Nepal. She trained early in the morning and on weekends, and made it to the top of Vinson Massif in 2001.

The following year, Alison took a position at the Goldman Sachs offices in San Francisco — just as the bottom was dropping out of the technology sector. And then fate struck: She received an E-mail from Mountain Guides International, an Alaska-based company that organizes climbing expeditions, asking if she wanted to lead the first American Women's Everest Expedition. Her boss graciously allowed her two months of unpaid leave to pursue her dream.

Alison's workout had kept her in good cardiovascular shape for climbing — she did sessions on a stairstepper with a 40-pound pack on her back — but she had to crank it up a couple of notches over the next three months to prepare for Everest. She also added a weekly 10-mile trail, spinning classes twice a week, weight training every other day and two sets of 40 push-ups a day.

“[C]limbing and surviving at high altitude will cause the human body to deteriorate regardless of how strong the body is to begin with,” Alison explains. “Part of the challenge was to trust that I'd be able to handle whatever came my way.”

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UNFORESEEN ADVERSITY

Figure. Levine cross...
Figure. Levine cross...
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Alison and four other women spent two months trekking up the imposing 29,000 feet of Everest to the top. After seven weeks of living in a tent, dealing with altitude sickness, using makeshift ice toilets and eating bad food, they made it past a rocky promontory known as the South Summit, some 300 vertical feet lower than the true top of the mountain. They were less than a football field away from their goal.

Suddenly, an unexpected “whiteout” of low clouds and blowing snow made visibility so low that they had to retreat. “It was harder to turn around than it was to keep going, but safety always has to come first,” Alison says. “You never feel defeated when you make a smart decision while climbing, just as in life. You need to know when to walk away.”

In 2004 Alison gave up her high-stress job to start a business consulting firm, appropriately named Daredevil Strategies. Alison is also a sought-after motivational speaker who advises that foresight, focus, flawless execution and a good sense of humor are essentials when dealing with any ever-changing landscape.

Alison also founded the nonprofit Climb High Foundation so she could combine her two passions: adventure and philanthropy. She has since trekked to the geographic North Pole to raise money for an orphanage in Uganda for children with speech and hearing impairments, and helped women living near the Rwenzori Mountains bordering Uganda and the Congo set up their own mountaineering outfits.

Just this past January, Alison became the first American to cross Antarctica to the South Pole via a 574-mile route from the Ronne Ice Shelf in west Antarctica that involved 38 days of skiing 10 hours a day while pulling a sled with 150 pounds of gear and supplies behind her. Since Italian explorer Reinhold Messner pionered the route in 1989, only two Norwegian teams had completed it.

“Antarctica definitely showed us her teeth,” says Alison, who endured −50° F temperatures, icy winds and dangerous crevasse fields covered with snow bridges that could have collapsed under the weight of her sled. “In these ... situations, you have to keep pushing on — there's no choice. I knew I couldn't just pop into a ski lodge for a cup of hot cocoa. Honestly, though, I love the challenge when it's just me against the elements.”

“Sometimes, a strong spirit can carry you further than just muscle alone.”

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What You Need To Know About Wolff-Parkinson-White (WPW) Syndrome

WPW occurs in approximately one to two cases per thousand births, and is the most common cause of abnormal tachycardias in infants and children.

About 15 percent of those with the condition never experience tachycardia, and will require no treatment. For others, ablation or medications including antiarrhythmics, beta blockers, calcium channel blockers, disopyramide and flecainide are effective in normalizing heart rhythm is required.

About 80 percent of people with WPW first experience symptoms between the ages of 11 and 50; symptoms typically worsen with age.

Episodes of WPW arrythmia typically last from a few minutes to a few hours, but may persist for as long as 24 hours.

WPW may result in a heart rate of 250 to 300 beats per minute, which is high enough to cause loss of consciousness or cardiac arrest. (A normal heart rate for adults is 60 to 100 beats per minute.)

© 2008 American Heart Association, Inc.

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