Rare complication during heart procedure kills activist

Posted by Mitchell - February 11, 2005 (entry 280)

(reprinted in the February 11, 2005 issue of the Grand Rapids Press
By Pat Shellenbarger and Ed White
The Grand Rapids Press

GRAND RAPIDS -- A complication during a procedure to correct an irregular heartbeat caused the death of a well-known community activist -- an outcome that occurs in fewer than 1 in 1,000 cases.

An autopsy Thursday found Dirk Koning, executive director of the Grand Rapids Community Media Center, died earlier that day after his heart began leaking blood during a heart catheterization at Spectrum Health's Fred and Lena Meijer Heart Center.

The so-called catheter ablation is one of the most-common methods of correcting an erratic heartbeat, known as atrial fibrillation.

The catheter may have perforated Koning's heart, causing blood to fill the sac surrounding it, Koning's wife, Ginger, said doctors told her.

Stephen Cohle, Kent County's chief medical examiner, said the autopsy did not reveal an obvious hole in the heart, but he said Koning, 48, died of medical complications during the procedure.

Ginger Koning said her husband experienced several episodes of a rapid heartbeat and decided to undergo the catheter ablation when drugs failed to control it.

Dirk Koning was awake with a local anesthetic Wednesday as a doctor threaded the catheter through a blood vessel into his heart. As the sac filled with blood, his blood pressure dropped and his heart stopped.

Doctors performed cardio-pulmonary resuscitation, but, because of the blood around the heart, were unable to sufficiently compress it, his wife said. During subsequent surgery, doctors repaired a hole in his heart, manually massaged it and got it beating again, she said.

"There was no way of knowing how much damage had been done to the brain," Ginger Koning said. "He didn't wake up. The blood pressure kept dropping, and at a certain point they couldn't do anything more. There was no brain activity."

He died at 3:15 a.m. Thursday.

Spectrum Health spokesman Bruce Rossman, citing state and federal confidentiality laws, declined to discuss the case but said it will undergo a thorough review.

He released a statement saying, "We're deeply saddened by the death of Dirk Koning, and we extend our sympathy to his family."

Catheter ablation was developed about 15 years ago and came into regular use in the past 10 years, said Dr. Douglas P. Zipes, an Indiana University professor who pioneered the procedure.

In a normal heart, electrical signals cause it to beat. But for about 2.2 million Americans, the electrical signals can become irregular, causing the heart to race.

During catheter ablation, a doctor, guided by X-rays on a video screen, directs the catheter to the area of the heart causing the abnormal signals. An electrode on the end of the catheter uses a radio frequency to destroy that small area of the heart.

Perforations of the heart occur in fewer than 1 percent of the cases, Zipes said, and fewer than 1/10th of one percent die from complications.

"You're looking at less than one in a thousand, basically," he said. "The outcome is unfortunate, since the patient died, but that doesn't mean the doctor did anything wrong."

Koning was hired to run the fledgling GRTV public access television station in the early 1980s. That station grew into the Community Media Center on Bridge Street NW, operating two cable channels, WYCE-FM, Internet service provider GrandNet Services, and the Grand Rapids Institute for Information Democracy.

At the time of his death, Koning was trying to create a wireless network offering free, high-speed Internet access in Grand Rapids and several suburbs. He also was raising $2 million to expand and create services at Wealthy Theatre.

Employees and volunteers at the Community Media Center cried and consoled each other Thursday.

"People are in shock," said Nancy Smith, a communications consultant.

Koning, who stood more than 6 feet tall, "was a giant in every way," GRTV director Chuck Peterson said. "He was incredibly charismatic. People just got inspired."

He also traveled the world to promote publicly accessible media.

In addition to his wife, Koning, who lived in Grattan Township, is survived by son Shaun, 19, and daughter Kelly, 17.

Visitation is set for 7 to 9 p.m. Saturday at O'Brien-Gerst Funeral Home, 3980 Cascade Road SE. Sunday hours are 2 to 4 p.m. and 7 to 9 p.m.

A funeral Mass will be offered at 11 a.m. Monday at St. James Catholic Church, 733 Bridge St. NW. In lieu of flowers, contributions can be given for the children's education or to the Community Media Center.

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