William Kostis, right, and Shawn Fohs


William Kostis, right, an assistant professor of medicine at Robert Wood Johnson Medical School and a cardiac electrophysiologist, saved the life of Shawn Fohs, left, who had Wolff-Parkinson-White syndrome, a rare heart malfunction.

John O'Boyle

One Sunday morning last summer, the day before the second birthday of his daughter Olivia, Shawn Fohs woke up feeling strange. His reliable 31-year-old heart, which had never caused him trouble, was suddenly beating so fast and irregularly that he thought he might be having a panic attack.

Grabbing his car keys, Fohs headed for the hospital. He made it out the front door before collapsing down the steps. The emergency responders summoned by his wife, Amanda, used a defibrillator six times to bring him back from the brink of death.

A day later, Fohs woke up at Robert Wood Johnson University Hospital, wondering how he’d gotten there. “It was rough because I didn’t have  a clue what was going on,” says Fohs, a computer  security consultant who lives in New Jersey’s Somerset County. “It took a day or so to figure out the cause and what, if any, permanent damage  there was.”

In charge of unraveling the mystery was William Kostis, who joined Robert Wood Johnson Medical School last spring as an assistant professor of medicine. Kostis ENG’94, RWJMS’07, who also holds a Ph.D. in electrical engineering, is a cardiac electrophysiologist, a cardiologist who  specializes in abnormal heart rhythms.

Tests showed that Fohs had the rarest—and most dangerous—form of an already rare disorder: Wolff-Parkinson-White (WPW) syndrome, a heart malfunction that affects fewer than three people in a thousand.

In patients with WPW, which was definitively described in 1930, the normal route that electrical signals travel between the heart’s top and bottom chambers is diverted through an abnormal extra pathway. In many patients, the congenital abnormality amounts to nothing more than an unusual pattern on an electrocardiogram test; in others, it can lead to disturbing but nonlethal symptoms like palpitations, dizziness, or fainting. But in a few patients, including Fohs, it can produce a heart rhythm abnormal enough to cause sudden cardiac arrest.

“Looking at his EKG, it was obvious that there was a pathway,” Kostis says. “It had just not been identified in the past and he had been otherwise healthy and asymptomatic.”

Fifty years ago, eliminating the life-threatening abnormal electrical pathway would have required open-chest surgery and a long recovery. Today, the fix is far less invasive. Fohs spent six and a half hours in the hospital’s electrophysiology lab, where Kostis threaded catheters through veins in the groin and up into the heart. With Fohs conscious but lightly sedated, Kostis deliberately replicated the abnormal heart rhythm that had led to Fohs’s  cardiac arrest, located the source of the problem, and then used heat to destroy a tiny amount of heart tissue, closing off the problematic extra pathway.

Fohs, a father of two—his younger daughter, Ava, is 10 months old—went home the next day, cured of his WPW and knowing that the chance of recurrence is, as Kostis describes it, “vanishingly small.” For a doctor, it’s particularly satisfying to cure someone young.

“You are always happy when you’re able to help any patient, but especially when you’re able to treat a life-threatening condition in someone who otherwise has a very long life expectancy,” Kostis says. “That’s always very rewarding.”

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