These heart rhythm experts don’t miss a beat

Published on Monday, June 1, 2020

By: Gary Pettus, gpettus@umc.edu

While electricity comes in handy for making toast, streaming Netflix or seeing in the dark, it has been powering a machine that’s much older and more essential than toasters, TV’s and street lights: the human heart.

The heart’s electrical system, or natural pacemaker, triggers the beat that keeps you alive, but sometimes that pulse goes awry, a condition that contributes to as many as 200,000 to 300,000 sudden deaths each year.

The disorder, called arrhythmia, is diagnosed when the heart beats too fast or too slow, and falls under the bailiwick of highly-trained medical subspecialists called cardiac electrophysiologists, or EP’s.

They are so primed and well-conditioned for the fight against heart disease that the University of Mississippi Medical Center has hired two of these experts to revitalize a program that can affect many patients’ lives: Dr. James “Mike” Bensler and Dr. James “Jimmy” Hamilton IV.

“We are building an EP section around them,” said. Dr. Michael McMullan, professor of medicine and director of the Division of Cardiology.

“It is extremely important for the care of our patients. The two biggest-growing areas of cardiology are structural heart disease and electrophysiology. EP’s have more ability than ever to treat advanced arrhythmias. What a difference they will make for our patients. We are fortunate to have them here.”

Just before they were here, Hamilton and Bensler worked at Baptist Medical Center in Jackson. “They are an integral part of our division already,” McMullan said.

Already, Hamilton, assistant professor of medicine, has started the Medical Center’s first consult service for a particular type of arrhythmia, atrial fibrillation, or AFib, a risk for stroke, heart failure, blood clots and more.

“The consult service aids in the management of inpatients with AFib, which is best treated by subspecialists; it’s the only such service in Jackson,” said Hamilton, who arrived at UMMC in August.

“It’s important to have a strong program in cardiac EP because it allows us to operate at the highest level of our technological abilities, which makes it safer for the patient.”

Their abilities are enhanced by the “greatest and latest” tools, McMullan said. “These guys can do everything, so we don’t have to refer patients out.”

The tools include devices that allow for better management of heart failure for their patients as well as advanced technology such as micro pacemakers, “which are smaller than a quarter, and have no leads,” McMullan said.

Pacemaker wires called leads may break, dislodge and drift away from the original site. With leadless pacemakers, patients avoid these complications.

Hamilton and Bensler are also adept at cardiac ablation, a procedure to fix arrhythmia by scarring or destroying in the heart the tissue that sets off or fosters the heart problem.

“It’s a tactical strike,” Hamilton said.

Bensler and Hamilton are also striving to make treatment more convenient for their patients. They switch duties week to week: While one does procedures daily at University Heart, the other one is seeing patients on the first floor of Select Specialty Hospital on Ridgewood Road.

“In the past, it could be a two-or three-month wait to see an electrophysiologist,” said Bensler, assistant professor of medicine, who re-connected with Hamilton at the Medical Center in January. “We pride ourselves on offering good access to care for our patients.”

Helping ensure that availability is a staff that includes EP registered nurse care coordinator, medical assistants, device clinic technicians and administrative assistants and more, all to accommodate, daily, at least 30 to 35 patients in the clinic, as well as remote cardiac device monitoring.

Patients in Mississippi have been seeing Hamilton and Bensler for years. Originally from Anchorage, Alaska, Bensler is a 2003 graduate of the University of Washington School of Medicine in Seattle. He did his residency at UW before taking on fellowships in cardiovascular disease and clinical cardiac electrophysiology at the Texas Heart Institute in Houston. 

He has been in the Jackson area for about a decade, including a stint at St. Dominic Hospital. “Mississippi is a great place to practice, a great place to work and a great place to raise a family,” Bensler said.

Hamilton, a Long Beach native, earned his undergraduate degree in chemical engineering at the University of Mississippi before graduating in 2007 from the School of Medicine at UMMC, where he also completed his internal medicine residency and a cardiology fellowship.

After finishing his electrophysiology training at Krannert Institute of Cardiology at the Indiana University School of Medicine, Hamilton returned with his family to Mississippi, where he worked for Baptist Heart for more than three years before joining UMMC as the EP section chief in August of 2019.

“Being here in Mississippi allows you to take care of the patients who need you the most,” he said. To that end, one of his goals as the EP section chief is to spread the program’s services throughout Mississippi.

“I want to build a program here that is nationally respected and capable of caring for the full range of cardiac arrhythmia disorders the state’s residents may face,” he said.

For people who are at risk of severe debilitation, who are living with such symptoms as shortness of breath, exercise intolerance, fatigue and chest discomfort, the heart of the matter is this, Bensler said: “All physicians have a profound impact on the quality of life for patients. But when a patient has a heart rhythm disorder, you can have an especially profound impact.”