WATERLOO - Little by little, Reuben Gonzales is learning about the inner workings of the heart.

At 79, he has dealt with his share of heart problems. He underwent triple bypass surgery in 1982 and since then has had five stents placed in his heart's arteries and a defibrillator installed.

"After 25 years and all of this, you learn a little about the heart," he said, from an operating table at Allen Hospital, just hours before undergoing another surgery to rectify an arrhythmic heartbeat.

It was during a routine check of Gonzales' defibrillator that Dr. Robert Hoyt noticed the irregularities. Hoyt is a cardiologist specializing in electrophysiology with the Iowa Heart Center in Des Moines. Electrophysiology is the study of the electrical activity of the heart.

Hoyt also works closely with Allen Hospital cardiologists to offer the same services in Waterloo. He visits the Waterloo hospital upward of seven times a month for surgeries and clinic consultations.

Thanks to newly purchased equipment and improving technology, patients like Gonzales can have these arrhythmia eradicated in an Allen Hospital operating room. Prior to this investment patients would have had to travel to Des Moines for Hoyt to perform the advanced procedures, said Paula Geise, Allen's director of cardiac services. Hoyt, who has partnered with the hospital since 1999, has completed about 10 procedures in the last six months since the equipment has been up and running.

Allen nurses and technicians are working closely with Hoyt's Des Moines staff to learn the intricacies of electrophysiology.

"This is not something you learn overnight," Geise said.

Neal Weers, a technician specializing in electrophysiology, often travels with Hoyt to help at hospitals outside Des Moines. His job description includes everything from running the elaborate equipment to throwing a patient's heart into arrhythmia so Hoyt can determine where the problem is occurring.

During the procedure Hoyt uses a catheter with an electrode on the tip. It enters into the patients body from the femoral vein in the groin area and threads through vessels to the heart. He watches the catheter's progress on one of seven flat screen computer monitors in the operating room. Once in place, the catheter and electrode map out the circuit that is causing the rapid heart rhythms, Hoyt said. Once the problem is detected he then uses radio frequencies to create a new path in the heart, which allows the heart to beat regularly again.

The procedure can last between one and five hours, but most are completed in just a couple of hours. Weers said eight to 10 years ago the same procedure would have taken all day and required the doctor to actually open the patient's chest. Now, it is usually done on an outpatient basis.

Gonzales, who returned home before nightfall on the day of his surgery, said it is a "blessing" that Hoyt can complete the procedure in Waterloo.

Hoyt, who is originally from Cedar Rapids, said he felt a strong desire to return to Iowa after completing his medical training.

"I got a job in Des Moines, but I'm very interested in working in my home area of eastern and central Iowa, helping people who have heart rhythm problems," said Hoyt, who serves as Allen's director of the cardiac electrophysiology lab. "Over the years I have developed relationships with the heart doctors here in Waterloo and I work very closely with them … Part of my professional life is to take care of people with these problems, and working with the heart doctors in this area and Allen hospital has become a big part of my practice."

Contact Emily Christensen at (319) 291-1570 or emily.christensen@wcfcourier.com.

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