First 4D ICE Cardiac Ablation Performed in Oklahoma at OU Health

Derrick White has never known what it feels like to have a normal heart.

Born without the lower right chamber of his heart, the 44-year-old from Loco, Oklahoma, spent his childhood in and out of operating rooms. While other kids played Little League, Derrick was learning to live with a heart that had to work twice as hard as everyone else’s. Surgeons rerouted his blood vessels, implanted artificial materials, and essentially rebuilt his circulation from scratch.

For most of his adult life, that meant long drives to Dallas whenever something went wrong.

Until OU Health offered a new reality.

In October 2025, Derrick became the first patient in Oklahoma to undergo a cardiac ablation using revolutionary four-dimensional intracardiac echocardiography (4D ICE), an advanced ultrasound imaging technology. The procedure, performed at OU Health, the University of Oklahoma’s academic health system, may have added years to his life.

A Unique Case

Derrick’s heart has had challenges that most adults have never experienced.

A healthy heart has four chambers that work like a perfectly choreographed dance. The two chambers on the right receive tired, oxygen-poor blood from your body and send it to your lungs for a refresh. The two on the left take that newly oxygenated blood and pump it back out to keep you alive. It is elegant, efficient, and something most people never think about.

Derrick was born with only one working bottom chamber. As a baby, his blood mixed together instead of flowing in two separate streams. Without surgery, he would not have survived.

Doctors in Texas performed a series of operations which essentially rewired his entire young circulatory system. They connected his veins directly to his lungs, bypassing the missing chamber entirely. It was lifesaving, but it was not a cure. His single ventricle would have to do the work of two and he would need ongoing, specialized heart care for the rest of his life.

“I’ve been doing it for so long, so it’s just like another day for me, to be honest,” Derrick said. “Somebody who’s never had heart conditions, I could see it being scary for them. But being used to it all my life, it’s kind of just the norm for me.”

Choosing Another Option

In 2017, Derrick decided he was done with Texas. His first wife passed away from a brain tumor following a long battle with cancer, and he had spent years making the drive to Dallas for specialized care. He was tired, grieving, and ready for something to change.

Local doctors in Ardmore, Oklahoma, could see him, but they openly admitted they were out of their depth. His heart was too unusual, too complex. They referred him to Oklahoma City, where he found OU Health cardiologist Dr. Anjan Shah, M.D., head of OU Health's adult congenital heart disease (ACHD) program and associate professor at the University of Oklahoma College of Medicine, who specializes in exactly the kind of patient most doctors never see.

“He seemed like a good guy and a good doctor, so I trusted him,” Derrick said. “He seemed very knowledgeable and knows what he’s talking about.”

Dr. Shah had been treating adults with congenital heart disease for years. He understood something that many people don’t realize. Patients like Derrick often fall into a gap in care. They are too old for pediatric cardiologists, but with heart conditions more complex than most adult heart specialists typically treat.

“They often see local cardiologists who don’t really understand their anatomy,” Dr. Shah said. “Not because they’re bad, but because they’re not trained in it. The patients are left feeling like they don’t really have anyone who understands or can care for them.”

For about five or six years, Dr. Shah monitored Derrick closely. He watched as his patient’s heart began developing dangerous new rhythms. Sometimes it beat too fast. Sometimes it needed to be shocked back into a normal pattern. The episodes were getting worse, and they were starting to damage his liver as poor blood flow affected its function.

Something had to be done.

Finding Solutions to Difficult Challenges

In 2022, Dr. Shah consulted with colleagues at Vanderbilt University Medical Center, as part of a collaborative approach to offer Derrick the highest level of care. They all agreed. Derrick would eventually need a heart transplant within five to 10 years. But if they could fix his rhythm problems first, they might be able to buy him precious time.

The solution was a cardiac ablation. Doctors would thread thin catheters through Derrick’s blood vessels, map the electrical signals in his heart, and use heat to destroy the tissue causing the abnormal rhythms. No incisions, no cracking open his chest, just precision and technology.

In 2023, they tried. But when doctors performed a pre-procedure exam, they discovered a blood clot hiding in the upper chambers of Derrick’s heart. If they proceeded, the clot could break loose and cause a stroke. They had no choice but to stop.

Derrick took it in stride.

“I’m more laid back when it comes to this stuff, so I just figured when they’re ready, they’re ready. The two years was worth the wait because then they had something even better.”

That something better arrived at OU Health in September 2025. It was an advanced ultrasound imaging technology called 4D ICE, and it would change everything.

A New Technology That Changed Everything

Traditional imaging gives doctors flat, two-dimensional pictures of the heart. Even 3D imaging requires time to construct — by the time you see the image, the heart has already moved on. But 4D ICE adds the fourth dimension of time to the picture.

With this technology, Dr. Shah could see Derrick’s heart in real time in three dimensions while working inside it, allowing him to precisely guide instruments, target the right tissue, and avoid surrounding structures.

“You get this three-dimensional picture in real time,” Dr. Shah said. “I can watch my catheter. I can correlate the electrical map with the structure of the heart. It lets me see everywhere I need to cauterize.”

OU Health was the first and only health system in Oklahoma to offer this technology. And Derrick would be the first patient to benefit from it.

The morning of Oct. 13, 2025, a team of the most experienced heart rhythm specialists in the state gathered in the catheterization lab at OU Health. Dr. Shah led the procedure. While Dr. Warren Jackman, M.D., professor at the University of Oklahoma College of Medicine and a legendary figure who helped pioneer cardiac ablation back in the 1980s and 1990s, came out of semiretirement to lend his expertise.

“Most places, when they do ablations, there is just one attending physician, and you kind of have to muddle through the complicated stuff,” Dr. Shah said. “OU Health has always taken the view of having two or three attendings. That means more pairs of eyes, more people looking at the surgery, which in turn means higher safety and a higher success rate. That pays off for patients like Derrick.”

Taking on the Most Complex of Cases

The most dangerous moment came early. To reach the chambers of Derrick’s heart, the doctors had to puncture through a wall of Gore-Tex material that surgeons had implanted during his childhood operations. Over the decades, that artificial tissue had become scarred, calcified, and treacherous. One wrong move could poke a hole in the heart and cause catastrophic bleeding.

“Doing a puncture in a Fontan patient is probably the highest-risk part of the case,” Dr. Shah said. “That’s the part where, if you do it incorrectly, you can perforate the heart and cause massive internal bleeding.”

But with the 4D ICE imaging, Dr. Shah could see everything. He guided his needle through the scarred tissue with perfect precision. A procedure that usually makes experienced surgeons hold their breath was over in five minutes.

“It was the easiest one I’ve ever done,” Dr. Shah said. “4D ICE made it so easy that it felt like you were cheating.”

The team mapped the electrical signals racing through Derrick’s heart. They found the circuit causing his dangerous rhythms looping around his mitral valve like a racecar on a track. Then, point by point, they cauterized the problem tissue, breaking the circuit for good.

By 2 p.m., they were done. The procedure had taken about 5 ½ hours. Fifteen years ago, a case this complex would have taken over 15 hours.

According to Dr. Shah, Derrick was the first adult patient with congenital heart disease in Oklahoma to undergo an ablation using 4D ICE imaging. He also noted that it is likely among the earliest uses of the technology in adult congenital heart cases in the United States since receiving U.S. Food and Drug Administration approval.

Getting Back to a Normal Rhythm

Since that October day, Derrick’s pacemaker has been tracking every beat of his heart. The results have been perfect, and he’s not had a single second of abnormal rhythm. His heart function is improving. His energy is coming back.

“I feel like I’m doing good,” Derrick said. “There are some days I feel a little tired still because I may have pushed myself too much. But other than that, I feel like I have more energy than what I did before the ablation was done.”

He will still need a heart transplant someday. That has not changed. But the ablation may have bought him 10 more years before that day comes. Ten more years for medical technology to advance. Ten more years for new treatments to emerge. Ten more years with his family.

Derrick remarried in April 2021, and he and his wife, are raising three children together. His oldest is 21 and his middle child is 11. And then there’s Charlie, his baby girl, who just turned 1 in December 2025. He also helps raise his 11-year-old niece. The house is loud. The house is busy. The house is full of life.

“You think about it just from a human level,” Dr. Shah said. “He has a little 1-year-old now. That kid has their father because of this. At a human level, it’s keeping families together. It’s keeping patients with their quality of life.”

Derrick’s story is not just about one man and one surgery, but about what is now possible in Oklahoma.

For decades, patients with complex congenital heart conditions like Derrick had no choice but to leave the state for advanced care. The expertise was simply not available. The technology did not exist. Families packed bags, drove hundreds of miles, and hoped for the best.

That era is ending.

“The goal is that no patient ever has to leave the state to receive care,” Dr. Shah said. “For rhythm care, we can now treat virtually all of these patients here in Oklahoma. Patients like Derrick should not have to go out of state for their care.”

OU Health is the only program in Oklahoma with 4D ICE technology for cardiac ablations. The health system has plans to expand even further, including a new dedicated intensive care unit for adult congenital heart patients and additional specialists joining the team. The future Dr. Shah has been working toward is finally arriving.

“If patients can hear stories like Derrick’s, then they know that we have these resources available for them,” Dr. Shah said. “They’re not alone. We’re here.”

If you or a loved one has a congenital heart condition or need advanced heart care, OU Health’s heart and vascular team is here to help. Visit OU Health's Heart and Vascular Clinic to learn more or schedule an appointment.