The following
program presents principles
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designed to promote
good health and is not
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intended to tak the place of
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personalized professional care.
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The opinions and ideas
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expressed are
those of the speaker.
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Viewers are
encouraged to draw their own
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conclusions about the
information presented.
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Praise God for I am fearfully
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and wonderfully
made. This is a beautiful
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quotation that is
found in the Psalms, welcome
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to Wonderfully Made. I
am so glad you took time
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out of your busy and
hectic schedules to join us.
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Today we're gonna
talk about the important
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topic of heart rhythms.
My name is Dr. Jim Marcum
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and I am a
cardiologist with a Chattanooga
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Heart Institute. And
with me today is Dan Miller,
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Dan Miller is a businessman from
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Chattanooga as well,
but he's also a consumer
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advocate of health
care. And I am so glad
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he's here and our goal
today is to talk to you as
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if we were right
there in the house with you,
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we collected questions
from all over the world
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dealing with this important
topic of heart rhythms.
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What we've done is
we, hopefully we can cover
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everything of
interest and Dan is gonna if we
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talk a little bit to
technical Dan is gonna
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sort of correct us and
slow us down a little bit
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and he is gonna make
this, everyone feels like
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we are right in here
living room today talking.
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So Dan with that introduction
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let's get going
with the questions.
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Okay thank Jim, the
first question is from
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Brenda she lives
in Atlanta and she's
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38 years old, she works
as an executive secretary
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and her question is
this, she has noticed that
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her heart pounds
and races at times.
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It usually happens
when she is preparing
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to go to bed and
it really bothers her,
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okay, what
could be causing this?
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Well Brenda, that is
an excellent question,
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many people especially
in your age group have
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this problem
with pounding hearts.
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Dan, have you ever had a problem
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with a pounding
hearts? Yeah, yes, I have.
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Now have you ever
notice any time of the
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day when this
pounding usually occurs?
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Generally in the evenings,
generally in the evening
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well that's a common
time when pounding does occur.
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And the reason
pounding occurs in is,
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there's so much
stimuli that goes on during the
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day and at the evening
time people start to notice
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and slow down a little
bit and they start feeling
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things that they
normally wouldn't feel when
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they're too busy during the day.
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Well Brenda, the most
common cause of this in
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your age group
would be some thing that's
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called premature
ventricular contractions.
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Sometimes we just
called as PVCs, this is
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very frequently,
now how do I know that
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without testing?
Well I don't, but the way
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we would test is
put, on a fancy device
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called a Holter
monitoring device.
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You've heard about a
Holter monitoring device?
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No, I haven't. Well let
explain a little bit about
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what a Holter
monitoring is, that's a
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special device we put
on electrodes and we can
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tell every beat of
your heart for x amount
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of time, we can
measure from 24 to 48 hours.
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And this is one of
the most useful tools that
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we have to detect
rhythms of the heart.
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Let's put up our
first graphic regarding
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premature ventricular
contractions or PVCs.
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Many different
things can cause these PVC's
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it could be a structural
abnormality within the
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heart that is the
heart doesn't work well,
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it's either too weak
or the valve's messed up
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or some other
problem. Caffeine in the United
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States, caffeine is a
frequent cause of PVC's,
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there's certain over
the counter drugs that
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can cause it,
especially those for cold
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medications that
have a substance called
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pseudoephedrine. And
stress is a cause of PVC's
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and there is host of
medical problems that
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cause these premature
ventricular contractions.
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So, this is very
common problem Brenda and
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getting back to
your question I would be
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very curious, if you
were my patient whether
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you did have a
structurally normal heart
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and I would ask you
a bunch of questions
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about the stress
and medications you were
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and we probably
wanna put a monitor on you.
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Does Brenda's age
have any bearing on
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any of this. Well
in pregnant years okay
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we think of PVCs as
something that's causing
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stress to the heart,
right. And that stress
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can come from anywhere,
it can come from the job,
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not sleeping while
at night, it could cause
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from a substance
like nicotine or caffeine,
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it could come from being scared.
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If I scared you Dan
today if I will boo,
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you would jump and
you might have a PVC.
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Well all these things
can cause the heart to skip,
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in this age group
another thing that
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we have to keep
in the back of mind
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is could this
person be pregnant.
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That would put a
definitely a stress
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on the heart. What
happens physiologically
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when they're under
stress you make a hormone,
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and that hormones
called Epinephrine,
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and that Epinephrine
is usually what causes
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the heart to
skipping beat, and one of the
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treatments that we
do if the skips are just
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unbearable, we
can't do anything as we
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try to block that
receptive with medications.
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So, Brenda what could
be causing this well back
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to your question, it
could be the medicines
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you take and it
could be that a rare
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cause be
structural abnormality but
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usually in your age
group it's just the stress of
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everyday life that's
causing the skip beats
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and that could cause
for many things, right.
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Alright, let's get
our second question then,
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this comes from Mel
in Toronto and the speed
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of his heart is about
38 to 42 beats per minute,
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he takes Atenolol,
Atenolol for high blood
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pressure and it's
making him very tired,
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do you think that
he needs a pacemaker?
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Oh okay, Mel,
that's a question we hear a
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lot of and before
I ask you a question,
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a lot of people
don't even know what a
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pacemaker is, have
you ever seen a pacemaker?
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I have not. Okay,
well I brought a pacemaker
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with me today, and
this is a pacemaker
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and it's keeps the
hearts going when it's
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not beating strong enough.
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And the way we have
this pacemaker is inserted
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right here under the
skin and here is a lead that
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goes inside the
right ventricular chamber
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and some time we put a
lead in the top chamber
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which is the right
atrium and this not only beats
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the heart but every
single beat that the heart
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does it can
monitor. And we have ways on
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a pacemaker we
can tell everything
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that's happening
within the heart.
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Now what is this
made out of him, okay.
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This pacemaker is
made of a substance and
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element called
titanium which is very stable
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in the body and
these are special plastics
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that go in the body the
body doesn't react to it,
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so you don't have a
bad reaction or anything
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like that. Pacemakers
are one of the most frequent
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treatments we
have for heart disease.
00:07:04.97\00:07:06.83
Before we had
pacemakers when the heart went
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slower and slower and
slower, it would just stop.
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Right. And if the
heart's not beating we have
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no blood pressure,
and one of the first
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pacemakers that went
in, I don't know if people
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realize this was a,
did you ever hear about
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Alfred Hitchcock? Yes
sir. Okay, well Alfred
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Hitchcock had one
of the first pacemakers
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and back in those
days the pacemakers were
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about the size of my
hand and it went in the belly.
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And that's what it took
to keep his heart going,
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but through the years
as you see the pacemakers
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have gotten smaller and smaller.
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And it's my prediction
the some day there are
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gonna be on the
size of a computer chip.
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Now can these be
monitored any other way then,
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how does the
monitoring process work?
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Well we have couple
ways we can monitor Dan,
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one of the ways we can
do it as with a hand held
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device over, that we
can tell every beat that
00:07:52.71\00:07:55.19
the heart has.
Another way nowadays we can
00:07:55.20\00:07:57.65
actually download the
information that's stored
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in these computer
chips on the Internet, right.
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And I can actually see
every beat of a patient's
00:08:03.48\00:08:05.92
heart for a long
period of time, in addition
00:08:05.93\00:08:08.01
to see how often
the pacemaker's used,
00:08:08.02\00:08:10.18
to see when it's
wearing out, to see when it's,
00:08:10.19\00:08:13.43
you know the battery
might need to be replaced.
00:08:13.44\00:08:15.44
So, you are saying I
could be traveling somewhere,
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oh yeah and you
could monitor me from
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a long distance.
Totally mobile with the
00:08:20.52\00:08:22.82
pacemaker you know
another thing the people
00:08:22.83\00:08:26.37
don't realize is some
people ask me can I get
00:08:26.38\00:08:29.18
into MRI's and magnetic fields.
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We usually advice not
to get in a MRI machine,
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right. Now an MRI
machine is a fancy
00:08:34.96\00:08:36.88
machine that
takes pictures of you,
00:08:36.89\00:08:38.60
because it's got
such a strong magnetic,
00:08:38.61\00:08:40.16
it can pull on
that, we don't want it
00:08:40.17\00:08:41.39
to be pulling
on someone's heart.
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It's just like in
airports and restaurants and
00:08:42.89\00:08:44.65
stuff like that
they've got the signs of that.
00:08:44.66\00:08:46.49
Right, you can still
go there but it would
00:08:46.50\00:08:48.24
detect metal in you,
and the alarms would go off,
00:08:48.25\00:08:51.16
so it's frequently
a cause of, especially
00:08:51.17\00:08:53.41
now with all the
problems we've had
00:08:53.42\00:08:54.79
at the airports it's
a very frequent problem.
00:08:54.80\00:08:57.17
But, you know what
we forget to answer
00:08:57.18\00:08:58.90
Mel's question here, yes we did.
00:08:58.91\00:09:01.50
Mel, making you
tired, well could the rhythm
00:09:01.51\00:09:05.18
be making you tired
is going 38 to 42 beats
00:09:05.19\00:09:07.92
per minute. A
normal runs about 70 beats
00:09:07.93\00:09:10.50
per minute, so the
rhythm itself might be making
00:09:10.51\00:09:13.09
you tired, or it
might be the Atenolol.
00:09:13.10\00:09:15.95
Atenolol is a
medication which slows down
00:09:15.96\00:09:19.39
the heart, it's slows
down the wiring of the
00:09:19.40\00:09:21.36
heart so that could
be making you tired.
00:09:21.37\00:09:23.15
Do you need a pacemaker?
00:09:23.16\00:09:24.88
A pacemaker is needed
usually when the heart
00:09:24.89\00:09:28.81
can't generate enough
blood pressure to supply
00:09:28.82\00:09:31.57
the brain. So, you
might feel dizzy, you might
00:09:31.58\00:09:35.17
pass out, you might
feel weak, those are
00:09:35.18\00:09:37.63
symptoms that would
say hey I think you might
00:09:37.64\00:09:40.05
need a pacemaker.
Let's go up to our
00:09:40.06\00:09:42.03
second graphics,
that has to do with when
00:09:42.04\00:09:45.98
a person might need
a pacemaker and here
00:09:45.99\00:09:47.88
the indications for a
pacemaker, the heart's
00:09:47.89\00:09:50.89
too slow, okay well
the mouse is going too slow
00:09:50.90\00:09:54.12
and he's tired well so
he's having some symptoms.
00:09:54.13\00:09:57.06
Usually we see
dizziness, so that
00:09:57.07\00:09:59.16
might be a
reason, conduction disease
00:09:59.17\00:10:01.64
what that means is the
actual wires of the heart,
00:10:01.65\00:10:03.89
the batteries, the
thing that keeps the heart
00:10:03.90\00:10:06.70
going or disease. And
the last thing is sometimes
00:10:06.71\00:10:10.40
people need to take
the medications to slow
00:10:10.41\00:10:13.22
the heart down.
The medications are so
00:10:13.23\00:10:15.91
important to slow the
heart rate that we put
00:10:15.92\00:10:18.29
a pacemaker in just
show the patient can take
00:10:18.30\00:10:20.89
the medications.
So, sometimes in that
00:10:20.90\00:10:23.19
emphasis those people
also need a pacemaker,
00:10:23.20\00:10:25.93
so but Mel is taking
a medication which could
00:10:25.94\00:10:29.12
slow his heart. So, the
first thing that I would
00:10:29.13\00:10:31.32
do with Mel here is
I, Mel, I would stop your
00:10:31.33\00:10:33.99
Atenolol and use a
different medication
00:10:34.00\00:10:36.57
to treat your
blood pressure and then
00:10:36.58\00:10:39.91
I would put monitor
on you, these Holter
00:10:39.92\00:10:43.72
monitors and see
how the rhythm's doing
00:10:43.73\00:10:45.28
and see if
anymore symptoms occur.
00:10:45.29\00:10:47.17
If more symptoms
don't occur I don't think
00:10:47.18\00:10:49.88
I would worry a
lot, now another thing
00:10:49.89\00:10:53.06
Dan I might do is I
would watch Mel's heart
00:10:53.07\00:10:54.99
rate when he walked.
You know lots of people,
00:10:55.00\00:10:57.43
athletics go very,
very slow when they're
00:10:57.44\00:10:59.56
not doing anything but
if it speeds up when you
00:10:59.57\00:11:01.64
do things that's
a great sign, right.
00:11:01.65\00:11:04.41
Now let me ask
you a question, okay.
00:11:04.42\00:11:06.45
Do you know many
people don't realize this,
00:11:06.46\00:11:09.77
do you know when
do think what part
00:11:09.78\00:11:11.31
of the day do you
think your heart goes
00:11:11.32\00:11:13.09
the slowest and what part
00:11:13.10\00:11:14.92
do you think it
goes the fastest?
00:11:14.93\00:11:16.61
I would say the
slowest would probably
00:11:17.70\00:11:20.08
be in my sleep, that's correct.
00:11:20.09\00:11:24.06
Fastest would probably
be when I first wake up,
00:11:24.07\00:11:28.43
that's right, if
you're not, that's great Dan,
00:11:28.44\00:11:30.55
you're on the top of
this if you don't have
00:11:30.56\00:11:32.88
a lot of stress on
your or other side stimuli
00:11:32.89\00:11:36.70
like you're getting
cut or hit, your heart's
00:11:36.71\00:11:39.48
gonna go
fastest in the mornings,
00:11:39.49\00:11:41.80
'cause the hormonal
system starts kicking in
00:11:41.81\00:11:43.81
and slows down in fact
I've seen people's hearts
00:11:43.82\00:11:46.08
on these monitors run
with no problems at all
00:11:46.09\00:11:48.67
run in 20s to 30s at
night, it goes pretty slow,
00:11:48.68\00:11:52.06
right and that's
when the body is resting,
00:11:52.07\00:11:53.49
the heart has the time
to catch up from the day.
00:11:53.50\00:11:55.78
So, Mel good luck
with your heart and
00:11:55.79\00:11:58.89
I hope that
answered your question.
00:11:58.90\00:12:00.98
Alright, let's go to
question number three,
00:12:00.99\00:12:04.86
it's from
Robert in Pennsylvania.
00:12:04.87\00:12:08.58
He says, I'm a
minister of a 1500 member
00:12:08.59\00:12:12.38
congregation in Pennsylvania.
00:12:12.39\00:12:15.57
We recently had
a parishioner die
00:12:15.58\00:12:18.43
after the morning
services, what are your
00:12:18.44\00:12:22.07
thoughts on getting
an automatic external
00:12:22.08\00:12:24.80
defibrillator, okay.
And most of his congregation
00:12:24.81\00:12:29.80
is elderly, so this is really
00:12:29.81\00:12:31.23
something that concerns him.
00:12:31.24\00:12:32.75
Okay, well this
defibrillator issue
00:12:32.76\00:12:36.17
is coming up
more and more, in the
00:12:36.18\00:12:38.87
Chattanooga area
recently we had a young
00:12:38.88\00:12:41.70
person that actually
died from one of these
00:12:41.71\00:12:44.84
dangerous heart rhythms, right.
00:12:44.85\00:12:46.51
It's very rare for
a young person to have
00:12:46.52\00:12:48.82
these in every year
you heard about a football
00:12:48.83\00:12:51.11
player that has one
of these abnormal rhythms
00:12:51.12\00:12:53.45
that was otherwise undetectable.
00:12:53.46\00:12:56.17
So, the issue is
should everyone in different
00:12:56.18\00:13:00.80
places carry
these defibrillators,
00:13:00.81\00:13:02.52
because you can get
a defibrillator to a
00:13:02.53\00:13:04.25
person quickly you can
literally save many lives,
00:13:04.26\00:13:08.29
right. And economics
that is you know should
00:13:08.30\00:13:12.89
these big churches
where there's lots of people
00:13:12.90\00:13:14.87
that could potentially
have an arrhythmia from
00:13:14.88\00:13:17.56
a heart problem die.
Now before I answer this
00:13:17.57\00:13:20.21
question I just want
to go over at of all the
00:13:20.22\00:13:22.90
causes of death in
America, the most likely
00:13:22.91\00:13:25.73
cause of death is gonna
be cardiovascular disease.
00:13:25.74\00:13:28.05
And a lot of people
don't realize that 43 percent
00:13:28.06\00:13:30.79
of all deaths in the
United States is due to
00:13:30.80\00:13:34.07
cardiovascular disease,
right. Now that's greater
00:13:34.08\00:13:36.54
then wars and
cancers and infections
00:13:36.55\00:13:38.93
and every thing combined.
00:13:38.94\00:13:40.25
An interesting
statistic is if you have a heart
00:13:40.26\00:13:43.48
attack guess how
many people you know
00:13:43.49\00:13:45.63
guess what
percentage dies before they
00:13:45.64\00:13:47.30
even make it to the
hospital from a heart attack?
00:13:47.31\00:13:49.35
I have no idea. 33
percent, most people
00:13:49.36\00:13:52.91
don't think it's
that high, right.
00:13:52.92\00:13:54.27
But, if you have
a heart attack there
00:13:54.28\00:13:55.52
is a one in three
chance that you are gonna
00:13:55.53\00:13:57.11
before you even
make it to the hospital.
00:13:57.12\00:13:58.96
That's why these
defibrillators are so much
00:13:58.97\00:14:02.34
in the news and so
much you know everyone
00:14:02.35\00:14:04.90
is want to talk about him.
00:14:04.91\00:14:06.25
So, thought on it
automatic external
00:14:06.26\00:14:10.29
defibrillator, I think
this would be an excellent
00:14:10.30\00:14:13.39
thing for your congregation.
00:14:13.40\00:14:14.72
And the training
involved really is very simple
00:14:14.73\00:14:17.75
in fact we brought
a defibrillator with
00:14:17.76\00:14:20.03
us today. At this
point time let me put this on
00:14:20.04\00:14:25.51
you Jim, but you
know and we're gonna sort
00:14:25.52\00:14:28.92
of pretend that and
the first thing we do
00:14:28.93\00:14:31.15
as we turn, and
show everybody how it
00:14:31.16\00:14:33.07
actually work. Right
it's not that hard to work
00:14:33.08\00:14:34.75
and you would be
surprised how easy it is to work
00:14:34.76\00:14:36.87
and if you are
looking at Robert if you are
00:14:36.88\00:14:39.59
looking at this show
this evening I want you
00:14:39.60\00:14:41.62
to sort of put this
in your back your mind
00:14:41.63\00:14:43.54
for your congregation,
lot of people think
00:14:43.55\00:14:46.54
it's hard to
work, but it's not very
00:14:46.55\00:14:48.60
easy okay is a device on?
00:14:48.61\00:14:50.51
You turn it on, okay
and we are gonna things
00:14:50.52\00:14:54.91
going here, okay I
think it's ready to open up.
00:14:54.92\00:15:01.12
You push the button on
the front of the machine,
00:15:01.13\00:15:03.15
the device opens up, and
you have to hit it again,
00:15:04.48\00:15:08.28
push it one more time.
00:15:08.74\00:15:09.71
Okay this device
we're gonna have to get it
00:15:14.85\00:15:18.97
going here, it's
suppose to come on here,
00:15:18.98\00:15:20.94
it talks to you actually
when it comes on, correct.
00:15:23.60\00:15:25.40
Now we have
trainer with me today,
00:15:25.75\00:15:27.70
so let's back up.
"Call for help now."
00:15:27.71\00:15:30.66
Here it goes, so
this point it's where
00:15:30.67\00:15:32.64
I call for health.
"Remove clothing from chest."
00:15:32.65\00:15:34.64
So I would remove
my. At this time right,
00:15:34.65\00:15:36.57
you'd laying on the
ground and I would take
00:15:36.58\00:15:38.45
your clothing
away from your chest.
00:15:38.46\00:15:40.22
We are going to
install this on our shirt,
00:15:40.23\00:15:43.88
so you will take your jacket.
00:15:43.89\00:15:45.23
"Pull red handle to open bag."
00:15:45.24\00:15:47.91
So, I would pull this out.
00:15:48.77\00:15:50.13
"Pull each pad off the plastic."
00:15:50.23\00:15:52.62
When you pull that out.
00:15:53.28\00:15:54.34
"And apply pad
to exposed chest."
00:15:54.35\00:15:56.69
You'll tear the
two pads in half.
00:15:57.80\00:15:59.36
"Remove clothing from chest."
00:16:03.96\00:16:06.19
It repeats that if you, correct,
00:16:06.20\00:16:07.71
if you don't do
something right or you can't.
00:16:07.72\00:16:09.59
This one actually
has a picture showing us
00:16:09.60\00:16:11.54
where to put the, okay the pad,
00:16:11.55\00:16:13.66
so I would apply
that on at that point.
00:16:14.44\00:16:16.65
"Pull red handle to open bag."
00:16:16.66\00:16:19.29
Okay, I would pull this one.
00:16:19.75\00:16:21.69
"Pull each pad off the plastic."
00:16:21.70\00:16:24.17
This one goes under your arms.
00:16:24.18\00:16:26.03
"And apply pad to exposed chest.
00:16:26.04\00:16:28.06
Do not touch patient.
Evaluating heart rhythm."
00:16:28.53\00:16:34.13
And this point in time
it automatically evaluates.
00:16:35.34\00:16:38.61
"Stand by." Okay.
"Preparing to shock.
00:16:38.62\00:16:41.87
Everyone clear." So I'm
gonna get out of the way.
00:16:41.88\00:16:44.20
"Do not touch
patient, delivering shock."
00:16:44.21\00:16:47.06
Okay, well as you can see,
00:16:50.87\00:16:53.15
was that the first
time you've ever done this?
00:16:53.66\00:16:55.64
Yes, it is. Now that
was not too hard to put on
00:16:55.65\00:16:58.98
and yet if I really
would have had a dangerous
00:16:58.99\00:17:01.63
heart rhythm that
potentially could have
00:17:01.64\00:17:04.03
saved my life. And
I would really wanted
00:17:04.04\00:17:06.84
this on that young
person that day, right.
00:17:06.85\00:17:09.31
You know that
happen to collapse in a gym
00:17:09.32\00:17:12.28
and I really want
this on because someone
00:17:12.91\00:17:14.86
could have been
trained to put this on
00:17:14.87\00:17:16.61
immediately it
would have saved his life,
00:17:16.62\00:17:18.27
correct. Now a
question we might get is
00:17:18.28\00:17:21.11
can you mess up
with one of these?
00:17:21.12\00:17:22.65
I mean can you be
shocked accidentally.
00:17:22.66\00:17:25.92
It is. I've never heard
it happening and this only,
00:17:25.93\00:17:28.45
the reason it
didn't shock me is because
00:17:28.46\00:17:30.13
my heart rhythm was normal.
00:17:30.14\00:17:31.20
But, it's only, it's
trained to only shock that
00:17:31.21\00:17:33.80
abnormal heart rhythm
which is called ventricular
00:17:33.81\00:17:36.53
fibrillation or
ventricular tachycardia, right.
00:17:36.54\00:17:39.22
That's the one you
see people over peoples
00:17:39.23\00:17:40.92
heart shocking
you know dramatically.
00:17:40.93\00:17:43.15
So, Robert
that's how you use these
00:17:44.82\00:17:47.24
and the prize of these
defibrillators are coming
00:17:47.25\00:17:50.07
down every year. One
of the questions that
00:17:50.08\00:17:53.06
comes up is what
about the liability issues?
00:17:53.07\00:17:55.89
You know are you
liable if you have one,
00:17:55.90\00:17:58.20
are you liable if you
don't have one, right.
00:17:58.21\00:18:00.91
And these are being
worked through right now,
00:18:00.92\00:18:02.83
but most people have
a short training course
00:18:02.84\00:18:05.57
they have to be
basic service support,
00:18:05.58\00:18:07.96
but when I, I talk
to people about what do
00:18:08.60\00:18:11.39
they need one of
these, I say, we just don't
00:18:11.40\00:18:13.60
choose it not to,
for the legal reasons,
00:18:13.61\00:18:17.22
I mean you want to
have this to save lives.
00:18:17.23\00:18:19.06
Save somebody's
life, you're correct.
00:18:19.07\00:18:20.38
And if you didn't
have it what would happen,
00:18:20.39\00:18:22.15
right and what's
the worse thing that can
00:18:22.16\00:18:23.78
happen if you
mess up? Do it over,
00:18:23.79\00:18:26.93
I would suppose.
Right, I mean but if you don't
00:18:26.94\00:18:28.69
even have the machine you know
00:18:28.70\00:18:30.09
someone is gonna,
you don't even have that
00:18:30.10\00:18:31.18
change. Exactly,
correct and if you don't get
00:18:31.19\00:18:32.69
the paramedics
there within five minutes
00:18:32.70\00:18:34.71
and deliver that
shock that patient has
00:18:34.72\00:18:36.77
very little ability
of having significant
00:18:36.78\00:18:39.36
long term recovery,
right. So, Robert there it is,
00:18:39.37\00:18:42.85
that's a defibrillator
and we hope you consider
00:18:42.86\00:18:45.97
getting it and if
there is anymore questions,
00:18:45.98\00:18:49.17
the people that run
these defibrillator companies
00:18:49.18\00:18:52.10
on the websites,
this one happens to be one
00:18:52.49\00:18:55.61
then by company called
Medtronic, they're more
00:18:55.62\00:18:58.98
than happy to give
information on this.
00:18:58.99\00:19:01.27
It's extremely
easy, okay now we stop it,
00:19:02.12\00:19:04.59
hope it doesn't go
off again, let's not.
00:19:04.60\00:19:06.03
Okay we don't want
it to start talking,
00:19:06.04\00:19:07.84
we got to finish this show Dan.
00:19:07.85\00:19:08.92
So, with that, let's
go to the next question.
00:19:08.93\00:19:11.06
Lets leave that
closed there and the next
00:19:14.39\00:19:17.57
question will be
from Lynette in Tennessee.
00:19:17.58\00:19:20.43
The speed of my
heart races at times,
00:19:21.71\00:19:23.96
I was at Disney
World a few years ago
00:19:24.58\00:19:26.59
and nearly
fainted from this rhythm.
00:19:26.60\00:19:28.57
I have two small
children and live
00:19:29.38\00:19:31.81
an active lifestyle.
This rarely occurs should
00:19:31.82\00:19:36.37
I will concerned?
Well, yeah the speed
00:19:36.38\00:19:40.26
of the heart
races, you can go ahead
00:19:40.27\00:19:42.07
and put that up if
you need to, Lynette,
00:19:42.08\00:19:44.39
this is a good
question, in the heart there are
00:19:44.40\00:19:47.41
some times groups of
cells that become very,
00:19:47.42\00:19:49.94
very unhappy. And
these cells can generate
00:19:49.95\00:19:52.95
a fast rhythm and sort
of generic name we give
00:19:52.96\00:19:56.63
for that is a
big name it's called
00:19:56.64\00:19:57.93
supraventricular
tachycardia, where the
00:19:57.94\00:20:00.77
heart goes real fast
and sometimes when the heart
00:20:00.78\00:20:03.66
goes fast like this you
don't get blood pressure
00:20:03.67\00:20:05.94
to your head.
And that's what makes
00:20:05.95\00:20:07.83
you feel so poorly,
one of the things we say
00:20:07.84\00:20:11.70
when it happens
okay lay down and
00:20:11.71\00:20:14.24
put your feet up
and you can sometimes
00:20:14.25\00:20:16.18
rub on this part of
your neck and some times
00:20:16.19\00:20:19.16
this will actually
slow your heart down enough
00:20:19.17\00:20:21.39
until you can catch your breath.
00:20:21.40\00:20:22.70
If it continues for
a long period of time
00:20:23.41\00:20:25.78
you really need to
go to the hospital,
00:20:25.79\00:20:28.34
so we can need a monitor on you,
00:20:28.35\00:20:30.05
or get an EKG to see
what this rhythms about.
00:20:30.06\00:20:34.28
Because you don't
want to be having this
00:20:34.29\00:20:35.53
rhythm when you go
down with your kids.
00:20:35.54\00:20:38.36
That could, a ride
at Disney World have
00:20:38.73\00:20:41.37
brought that about.
Yeah I guess it's possible
00:20:41.38\00:20:45.37
but usually these
rhythms are triggered
00:20:45.73\00:20:47.73
on their own. Most
people have these that
00:20:47.74\00:20:51.36
they're doing nothing
and then it just comes on.
00:20:51.37\00:20:53.41
Now we do know that
there are some triggers
00:20:53.84\00:20:55.39
that make it worse,
if you're dehydrated,
00:20:55.40\00:20:57.13
and some times you
can take a stimulant
00:20:57.73\00:20:59.84
from the heart,
and some of more common
00:20:59.85\00:21:01.48
stimulates that you
might see at a theme part
00:21:01.49\00:21:03.62
would be stress from
two small kids all day.
00:21:03.63\00:21:05.70
Standing in line,
yes if you don't have to
00:21:05.71\00:21:07.56
fast passes, you have
to stand in life a lot
00:21:07.57\00:21:09.68
at Disney World.
Another thing we talked
00:21:09.78\00:21:12.44
about caffeine and
if you get dehydrated.
00:21:12.45\00:21:14.42
If you're not
drinking all day don't have
00:21:15.29\00:21:16.63
enough fluid, those
are some other things
00:21:16.64\00:21:18.18
that could trigger this rhythm.
00:21:18.19\00:21:19.25
And the people
just have it rarely
00:21:19.57\00:21:21.19
I recommend no
treatment just monitor,
00:21:21.20\00:21:23.33
but if it happens
on a regular basis more
00:21:23.34\00:21:25.57
frequently, we can
actually go up inside the
00:21:25.58\00:21:28.20
body and destroy these dangerous
00:21:28.21\00:21:30.20
heart rhythms now
with the small about
00:21:30.21\00:21:31.73
of energy, right. And
if people don't wanted
00:21:31.74\00:21:33.88
to do that, we can
also take medications.
00:21:33.89\00:21:35.82
Now is it a person's
fault that they have this,
00:21:35.83\00:21:37.85
that's you know no, not really.
00:21:37.86\00:21:40.03
Most people are just
sort of born that way
00:21:40.04\00:21:41.80
and they have
these abnormal pathways
00:21:41.81\00:21:43.33
and they have to just
live with that, right.
00:21:43.34\00:21:45.08
So, Lynette, good
luck with your rhythm
00:21:45.09\00:21:46.84
and if it keeps
coming on I would
00:21:46.85\00:21:48.60
go see your
health care provider.
00:21:48.61\00:21:50.23
Alright, next question
is from Earl in Minnesota,
00:21:51.79\00:21:56.73
okay. He says
atrial fibrillation runs
00:21:56.74\00:22:02.03
in my family. I'm
86, my doctor says
00:22:02.04\00:22:06.71
I have atrial
fibrillation and he wants to put
00:22:06.72\00:22:11.05
me on a blood
thinner. I don't want to,
00:22:11.06\00:22:14.16
okay, what do you think?
00:22:14.17\00:22:15.77
Okay, atrial fibrillation
is another one of these
00:22:15.78\00:22:20.26
rhythms of the heart.
Now we don't talk much
00:22:20.27\00:22:23.08
about it earlier, but
the normal rhythm is called
00:22:23.09\00:22:25.32
a sinus rhythm,
right. That means each rhythm
00:22:25.33\00:22:27.85
is generated from
the special battery that
00:22:27.91\00:22:30.00
God give us
called the sinus nerve.
00:22:30.01\00:22:31.95
That's a normal rhyme,
so if it's going too slow
00:22:32.49\00:22:35.11
we called that sinus
bradycardia or too slow
00:22:35.46\00:22:38.59
of heart rhythm. If
it's going fast we called it,
00:22:38.60\00:22:40.53
tachycardia.
Those are normal rhythms
00:22:40.54\00:22:42.93
of the heart, but
just going slow for another
00:22:42.94\00:22:44.76
reason, right. Some
times you could have
00:22:44.77\00:22:47.76
sort of these
missed connections that
00:22:47.77\00:22:50.09
we talk about, and
it's coming from the top
00:22:50.10\00:22:52.04
part of the heart
this abnormal firing from
00:22:52.05\00:22:54.41
all sorts of funny
spots, we call that
00:22:54.42\00:22:56.82
atrial fibrillation.
And that's with the top
00:22:56.83\00:22:59.49
part is
literally going like this,
00:22:59.50\00:23:01.32
it just squeezing all
over, it's not working
00:23:01.33\00:23:04.28
symmetrically with the
bottom part of the heart,
00:23:04.29\00:23:06.41
right. And guess
what happens to blood,
00:23:06.42\00:23:08.40
if a heart squeezing
like a bag of worm where
00:23:08.41\00:23:11.35
it comes through. Squeezed out,
00:23:11.36\00:23:13.43
well it's from of a squeeze out,
00:23:13.44\00:23:15.13
but as much as
normal. But, actually when
00:23:15.14\00:23:16.83
it's moving like this
you can get blood clots,
00:23:16.84\00:23:19.68
okay, the blood
doesn't pass through.
00:23:19.69\00:23:21.24
And if a blood clot
gets in there and it passes
00:23:21.73\00:23:24.01
through from the
upper chamber to the lower
00:23:24.02\00:23:25.72
chamber and the
lower chamber pumps
00:23:25.73\00:23:27.73
that blood clots
somewhere it could go
00:23:27.74\00:23:29.68
to the head and cause stroke.
00:23:29.69\00:23:31.84
In fact about 15
percent of all strokes
00:23:32.84\00:23:36.18
in the United States
are cause by this rhythm
00:23:36.63\00:23:39.36
atrial fibrillation. So,
Earl, that's why your doctor
00:23:39.37\00:23:44.62
what's to put you
on a blood thinner.
00:23:44.63\00:23:46.20
He wants to lower your
risk of having a stroke.
00:23:46.21\00:23:49.16
Now is there some
people that don't get
00:23:49.83\00:23:52.06
a blood thinner, you
know yeah if the risk
00:23:52.07\00:23:55.71
of bleeding out ways the
risk of the blood thinner
00:23:55.72\00:23:58.94
then you aren't good.
And have to have frequent
00:23:58.95\00:24:01.22
monitoring when
you're on coumadin.
00:24:01.23\00:24:03.03
Now do you know
what coumadin rally is?
00:24:03.04\00:24:04.65
I don't know, what is that?
00:24:04.66\00:24:06.26
Okay, coumadin is rat
poison, a lot of people
00:24:06.27\00:24:09.29
don't like to realize
it's just a rat poison
00:24:09.30\00:24:11.32
and a lot of people
don't like to take it
00:24:11.33\00:24:12.71
because it's rat poison, right.
00:24:12.72\00:24:14.37
But, it has lowered
the risk of having a blood
00:24:14.38\00:24:17.14
clot in the body. And
in atrial fibrillation
00:24:17.15\00:24:20.02
you have to evaluate
the risk of being on the
00:24:20.03\00:24:22.05
blood thinners,
whether you can taking the
00:24:22.06\00:24:23.95
monitoring versus
the risk of falling and
00:24:23.96\00:24:26.54
bleeding, these are
all very important things
00:24:26.55\00:24:29.44
to think about
when you're on coumadin,
00:24:29.45\00:24:31.19
but Earl if you
came to me and you had
00:24:31.20\00:24:33.16
atrial fibrillation,
first of all I would say,
00:24:33.17\00:24:37.72
you know coumadin
needs to be considered,
00:24:37.73\00:24:39.43
but the next thing
I wanna look is the
00:24:39.44\00:24:41.03
different causes. You know why,
00:24:41.04\00:24:42.53
correct it's a
very common rhythm
00:24:42.54\00:24:44.37
and with that my let's
bring up the next graphic
00:24:44.38\00:24:46.90
about the causes of
atrial fibrillation.
00:24:46.91\00:24:49.54
Okay, remember, this
is where the top part's
00:24:49.55\00:24:52.23
going faster
then the bottom parts.
00:24:52.24\00:24:54.00
Sometimes it can
again be because there is
00:24:54.01\00:24:55.88
something wrong
with the heart itself.
00:24:55.89\00:24:57.61
That is there is a
structural heart problem,
00:24:57.62\00:24:59.83
you know it might be
that it's stretched out,
00:24:59.84\00:25:03.16
it might be the
valves are bad, there might
00:25:03.17\00:25:05.19
be an old heart
attack. Some thing's wrong
00:25:05.20\00:25:07.22
with the heart
itself that's causing it.
00:25:07.23\00:25:08.92
Sometimes you can
have a thyroid condition,
00:25:08.93\00:25:11.08
remember the thyroid
regulates these rhythms.
00:25:11.09\00:25:13.23
You can have a
thyroid abnormality,
00:25:13.24\00:25:15.04
sometimes high blood
pressure can actually
00:25:15.05\00:25:17.10
cause high blood,
could cause this rhythm,
00:25:17.11\00:25:19.26
atrial fibrillation,
because it stretches it out.
00:25:19.27\00:25:21.25
And there's a host
of other causes and Earl
00:25:21.26\00:25:24.47
I wanna sort of go
though some of those other
00:25:24.48\00:25:26.15
causes with you just
in cause you might have
00:25:26.16\00:25:29.39
one of these, again
we talked about being
00:25:29.40\00:25:32.17
dehydrated, right,
having an infection,
00:25:32.18\00:25:34.48
certain medications
can sort of cause it be
00:25:34.49\00:25:37.80
more likely to
happen. Just being sick can
00:25:37.81\00:25:40.72
cause it happen,
correct. Now one of the things
00:25:40.73\00:25:43.08
the heart likes most
is oxygen, okay and we
00:25:43.09\00:25:46.54
found that people
don't get enough oxygen,
00:25:46.55\00:25:48.46
so if Earl has a
lot of lung disease,
00:25:48.47\00:25:51.07
that could a trigger for
this atrial fibrillation,
00:25:51.08\00:25:54.25
right. And in this
rhythm you feel pretty
00:25:54.26\00:25:56.07
bad if it's, the
heart is going too fast.
00:25:56.08\00:25:58.04
So, atrial fibrillation
is one that you usually
00:25:58.05\00:26:01.22
you have to go in the
hospital to get it treated,
00:26:01.23\00:26:02.88
so it's a pretty
tough thing to have.
00:26:02.89\00:26:05.46
So, I think
coumadin is reasonable and
00:26:05.47\00:26:07.38
the other thing you
know if we can fix the
00:26:07.39\00:26:09.40
underline cause.
You know if Earl if you
00:26:09.41\00:26:11.78
have problems with
your lungs is infection,
00:26:11.79\00:26:13.76
you are not
getting enough oxygen,
00:26:13.77\00:26:14.74
let's fix that. Right,
now do you have to do test
00:26:14.75\00:26:20.04
to balance the amount
of coumadin that you're
00:26:20.05\00:26:21.92
getting, can you
get too much, could be?
00:26:21.93\00:26:23.88
Yes, you can, we
have to frequently check
00:26:23.89\00:26:25.87
the blood to see if
the blood is too thicker
00:26:25.88\00:26:28.37
or too thin
while in the coumadin,
00:26:28.38\00:26:29.66
because if it's too
thin and you bonk your head,
00:26:29.67\00:26:31.84
you could have a
very, very serious problems.
00:26:31.85\00:26:34.10
Right, right you
know in the slide you also
00:26:34.11\00:26:40.45
mentioned that
the thyroid has a lot.
00:26:40.46\00:26:43.14
Yeah. There are a lot
of people with thyroid
00:26:43.15\00:26:45.91
problems in the
United States, they would
00:26:45.92\00:26:47.74
seems like, yeah, I
personally have some
00:26:47.75\00:26:51.04
problems with mine,
and so that's something
00:26:51.05\00:26:54.73
that's even beneficial
for me to remember, right.
00:26:54.74\00:26:58.37
You can go you
know too low, too high,
00:26:58.38\00:27:00.24
thyroid is very common
regulator of the heart,
00:27:00.25\00:27:02.57
it regulates the hearts speed.
00:27:02.58\00:27:03.75
Actually, a lot of
people don't realize but a low
00:27:03.76\00:27:06.16
heart rate can cause
you to have slow heart.
00:27:06.17\00:27:10.31
Now before we close
today I wanted to show
00:27:10.32\00:27:12.96
the people we've
talked about rhythms,
00:27:12.97\00:27:14.51
we talked a little
about the slow ones,
00:27:14.52\00:27:16.34
right, a little bit
about the fast ones.
00:27:16.35\00:27:18.24
And today I just
want you to get interested
00:27:18.25\00:27:19.96
in your heart rhythm.
One other thing I like
00:27:19.97\00:27:22.33
to show you that we
brought with us today
00:27:22.34\00:27:24.24
this is a
defibrillator, remember,
00:27:24.25\00:27:26.64
earlier in the
show we had an external
00:27:26.65\00:27:29.23
defibrillator. Now what
an external defibrillator
00:27:29.24\00:27:31.50
is a device that
we put on immediately,
00:27:31.51\00:27:34.63
when someone's
having a sudden problem with
00:27:34.64\00:27:37.75
their heart. Now this
device and people with
00:27:37.76\00:27:39.56
weak hearts or people
that have diseased heart
00:27:39.57\00:27:41.66
that needs this
technology all the time,
00:27:41.67\00:27:43.94
this can be
inserted under the skin and
00:27:43.95\00:27:46.14
it can deliver a
shock and this one can
00:27:46.15\00:27:47.82
actually pace the
heart anytime it might
00:27:47.83\00:27:50.12
be needed. Well
we're almost out of time
00:27:50.13\00:27:52.72
today Dan. I wanna
thank you for joining us,
00:27:52.73\00:27:54.57
and I hope that the
audience has learned
00:27:54.58\00:27:56.61
something about the
rhythms of the heart,
00:27:56.62\00:27:58.20
the fast ones, the
slow ones, a little bit more
00:27:58.21\00:28:00.67
knowledge about what to do.
00:28:00.68\00:28:02.21
And we hope that all of
you can have hearts that
00:28:02.22\00:28:05.27
never go out of
rhythm and we hope that God
00:28:05.28\00:28:07.90
will create new, a
new heart, one that
00:28:07.91\00:28:10.33
depends on him daily to keep
00:28:10.34\00:28:12.31
your heart running smooth.
00:28:12.32\00:28:13.96