Participants: Dr. James Marcum (Host), David Wendt
Series Code: BRX
Program Code: BRX00014A
00:01 Are you being confused by the conflicting health reports
00:04 in the news today?
00:05 In this well marketed world is hard to know who or
00:08 even what to believe, but there are answers that
00:10 you can depend on.
00:12 Hi I'm Dr. James Markham, join me for Bible RX, a program
00:16 exploring the health care world, looking at all aspects
00:20 of healing, using the Bible and Biblical prescriptions
00:25 as the ultimate source of truth.
00:53 Today we have Dr. David Wendt, Dr. Wendt is a
00:56 Electrophysiologist, one of the best-known in this area.
00:59 We are glad to have him answering
01:01 questions on electrophysiology.
01:03 Join us today as we explore the fascinating field of
01:07 electrophysiology with Dr. David Wendt.
01:15 As a general cardiologist, I frequently see patients
01:18 that need Dr. Wendt services.
01:20 They may have a heart that is going to slow or too fast.
01:23 We might do everything we can with medication or changes in
01:27 lifestyle and we still have hearts that aren't doing
01:30 quite right so we are lucky that we have Dr. David Wendt
01:32 here today to answer some of our specific questions.
01:35 I would like to ask you Dave, how did you get interested
01:38 in the field of electro- physiology and cardiology?
01:42 How did your journey reached this point?
01:44 Good question, you know my father was an Internist, when
01:47 I grew up and we had seven kids and the only way
01:51 I thought I could ever talk to him, because he was so
01:53 busy if I showed an interest in science that
01:55 was an entrée for that.
01:57 Of course you go to the natural rebellion as a kid and
02:00 I found myself in Calvin College which is
02:04 a Christian college in Michigan.
02:05 They had a very good science program and
02:07 I gravitated towards that.
02:09 As I went further along in it, I found there were areas
02:12 of medicine as there are today.
02:14 People just don't understand what is the reason for a
02:18 particular illness or entity.
02:20 As I went through my cardiology rotations, the big one
02:23 was why are people dying suddenly?
02:26 What is this thing called Ventricular Tachycardia?
02:29 What are these fast heart rate that people had?
02:32 Most of my professors had very little knowledge of those
02:36 things, so when I went into my fellowship this virgining
02:40 field of electrophysiology was suddenly on the forefront
02:44 of discovering these things.
02:46 That really peaked my interest at the time.
02:48 I think one of the things as we go through our lives
02:51 there are these maxims we have in our faith.
02:53 Be still and know that I am God, and you find a quiet
02:57 space in your heart and make yourself calm.
02:59 But when your heart is beating irregularly, it creates
03:03 a great deal of anxiety in a patient or an individual.
03:06 So this became a very intriguing journey for me.
03:09 How do these hearts do the things they do?
03:12 How do they keep steady?
03:13 What triggers them to be chaotic? And why?
03:17 What do we do to stop that?
03:19 It was very interesting starts.
03:21 We also know this field has grown enormously,
03:24 the treatments and the devices we have now actually
03:28 help tremendously that we did not have 20 years ago.
03:31 No we didn't, there is a fellow named Earl Botkin who
03:35 years ago in the late 50s met with a surgeon in
03:38 Minneapolis, Dr. Lily Hi, and he had some adolescent
03:41 children there and the surgeon came to him and said
03:44 if we don't do something for these kids,
03:46 they are going to die.
03:47 So he went to his garage, put together some wires and
03:51 an alternator battery and they implanted them.
03:54 These were the first pacemakers for our country.
03:56 - Really? These kids made it and found that in that
03:59 auspicious beginning we have all these medical companies
04:02 better driving this technology which is remarkable.
04:05 We are going to talk about that, what we've done,
04:08 we have collected questions from all over the world,
04:11 all over the United States regarding electrophysiology
04:14 and grouped them together.
04:15 If you might have a question on electrophysiology or
04:18 any other medical field we want to invite you to visit our
04:21 website which is: heartwiseministries. org,
04:24 or you can write to P.O. Box 8, that is:
04:27 Heart Wise Ministries P.O. Box 80 Ooltewah TN 37363
04:31 Well we are going to move on to our first question now.
04:34 This first question comes from an 83-year-old who has
04:38 recently been to the doctor.
04:39 He said he's on no medication and he feels well, however
04:43 recently he found that his heart is going very, very
04:46 slow and his Internist is recommending he see a doctor
04:50 about pacemaker, so his question to us is who might need
04:54 a pacemaker and let's explain a little bit about
04:57 what it is and what it does.
04:59 Well of course when we are born are heart rate is
05:02 usually around 82-100 beats per minute.
05:04 When you read the textbooks as we all read, the average
05:07 heart rate is 72 beats per minute.
05:08 That goes up and down depending on our activity.
05:11 If you're Lance Armstrong your heart rate may be 40 beats
05:16 a minute so it is individualized but as we age these cells
05:20 age and normally trigger the rate of the heart die off
05:25 a bit and it is very common when we get into her 80s and 90s
05:28 for our heart rates to slow down.
05:29 If that's slowness starts to cause symptoms, particularly
05:34 dizziness, tiredness, shortness of breath or passing out.
05:38 Then that is a point in time certainly were something needs
05:42 to be done to intervene, and a pacemaker, as we just talked
05:45 about, is the tool today that we use to prevent that
05:49 heart rate from getting too slow.
05:51 There are very wonderful sophisticated devices that are
05:54 very easy to implant today, they've gone through a lot of
05:57 iterations of technology but they are life-saving and
06:01 life changing for many, many people.
06:03 Now how big is a pacemaker?
06:04 Well I am glad you brought that up.
06:06 This one is one of the bigger pacemaker's, this actually
06:10 has three leads into it, but most pacemakers just have
06:13 2, one lead goes to the upper chamber of the heart and
06:17 the other to the lower chamber of the heart.
06:19 They are about the size, as I said a little bigger,
06:22 about the size of a silver dollar or half dollar.
06:25 They are fairly thin and you can feel them under the
06:28 skin but they don't really protrude at all.
06:30 The battery and the computer in them lasts about eight to
06:34 10 years today, so they are actually quite remarkable
06:37 pieces of technology.
06:39 Now we got lots of questions about pacemakers.
06:42 Can patients with pacemakers go through MRIs?
06:45 Can they get CAT scans?
06:47 Do they go off when you go to the airport?
06:49 We get those questions a lot. - all the time.
06:50 They are working feverishly, there is now a company and
06:54 some devices are now MRI safe, they are not yet released
06:58 by the FDA.
06:59 Most the time could have a CAT scans or in CT scan without
07:02 any difficulty at all the other imaging modalities as
07:05 long as they don't use the big magnets are fine.
07:07 But when you start to go through airport security they
07:10 are going to shut the alarm off, turn the alarm on and of
07:13 course they are going to say are you carrying something
07:17 illegal? But we tell our patience is to take the card
07:20 and presented to the security personnel and they will do
07:23 a hand search, or a wand search and get
07:25 you through without any trouble.
07:27 Theoretically they have had reports were if you stand in
07:30 the pylons of the metal detectors at department stores,
07:35 that can interact with the battery too, but reports
07:38 have been where an individual in a wheelchair that has
07:42 been left by his family between these pylons and it talks
07:45 to a little bit, you probably don't want to do that.
07:48 This always comes up, but what about pacemakers and
07:50 cell phones? Can pacemakers and cell phones have
07:53 any relationship at all?
07:54 There are certainly some interactions that can occur.
07:57 If you have your cell phone right over the pacemaker,
08:00 or if you are someone who wears your phone in the pocket
08:02 and the pacemakers right there, you are probably going
08:05 to have change pockets.
08:06 And you know we say gee stay 4-6 inches away from the
08:10 device with the phone if you can,
08:12 but I have to say that over the years of doing this,
08:15 I have yet to have someone who has had an adverse
08:17 interaction with a cell phone.
08:19 Now this gentleman is 82, what would happen to him if
08:24 he did not have a pacemaker?
08:26 What would be the natural history, I mean would he be
08:29 okay, would he die, I guess that is impossible without
08:33 knowing all the details.
08:34 If we take a general setting, let's say that he has a
08:38 blockage in the upper and lower conduction system,
08:41 between those two it is usually progressive and at some
08:44 point in time either the heart rate will get very slow,
08:47 in the 20 beats per minute range.
08:49 Or potentially it could be walking down a stair or even
08:53 driving and actually passed out.
08:54 So we like to be able to preemptively deal with folks
08:58 that we know are on the path and try
09:00 to prevent that from happening.
09:02 I guess the point I would like to bring out is that
09:04 before we had pacemakers these patients would die or
09:07 have dangerous accidents and now we can prevent that.
09:09 Yeah, yeah. - we have a lot of people that will
09:12 will call in and say you believe in God and do not
09:14 believe in modern medicine.
09:16 God has really given us modern medicine to enhance our
09:18 life and I can't think of anything more that increases
09:21 longevity than pacemakers.
09:23 I think that is right and the question I always get from
09:26 families is if my grandma has that pacemaker, does that mean
09:29 she's going to live forever?
09:31 Does that mean when it is her time to go that pacemaker
09:34 will keep her alive? And the answer is no.
09:36 When God calls us we are go to go whether we have a
09:40 pacemaker in or whether we have a nuclear defibrillator,
09:43 it's not going to stop that process.
09:45 It's not that uncomfortable nowadays.
09:47 Our next question is actually from a 30-year-old female.
09:51 The question is:
09:53 she says she does not pass out but it bothers her greatly.
10:04 So she sounds like she's having some palpitations.
10:06 I think this one is pretty common.
10:08 I'd say this is one that you guys see all a time.
10:10 Again I think so much depends on the individual, part of
10:13 what we do as physicians is that we very carefully go to
10:17 the history, many people have palpitations,
10:19 we used to call them bumps in the night.
10:21 I use to give a talk about that, it was a community
10:24 talk and the room was filled with people because
10:27 it is not uncommon.
10:29 But there are settings like that that are more serious,
10:32 there is a family history of sudden death, or if we can
10:36 get tracings and show that the rhythms are going extremely fast
10:39 or showing particular patterns that are more potentially
10:43 life-threatening then we move towards more invasive
10:45 testing for a more serious look at things.
10:48 Many times, I'd say 90% of the time it's an extra beat
10:52 from the top or the bottom of a heart that is from part
10:56 of the heart that is innocuous or benign in origin.
11:00 Then the choice is, for someone that young, you want to
11:03 take a medicine for the next 20 years that has its own
11:06 side effects or if by explaining this to you can
11:09 you overcome what anxiety might be there and just leave
11:15 it alone and go forward.
11:16 That is an individual patient decision.
11:19 One of the approaches I use, you know these palpitations
11:23 are an underlying problem, God did not make us to have
11:26 palpitations and once we realize that it is nothing
11:29 serious we say what can be stressing the system.
11:32 That's a very good point.
11:33 Sometimes it can be caffeine, sometimes not getting enough
11:36 sleep, or they might have personal relationships that
11:39 aren't right, I tell them there is something wrong with them no
11:41 doubt but nevertheless we can find out what that is and
11:46 remove that stressor maybe we can be more in harmony with
11:50 the way we were created.
11:51 That is a great point, I think so often we get focused on
11:54 the pathophysiology and then you have to step back and say
11:57 okay if you have a child that has been ill, doing bad in
12:01 school, is your marriage hitting a rough spot, what is going
12:04 on here that has pushed you from someone who had
12:06 no symptoms to suddenly be dealing with it?
12:09 Everybody today, with the economy, the job,
12:12 everybody has a degree of stress that they didn't have
12:15 5 or 10 years ago.
12:17 This is important question because I think a lot more
12:20 people are going to have palpitations coming up.
12:21 With our health care system we ask what is a reasonable
12:25 approach in handling the problem of palpitations.
12:27 Of course you want a good history and physical and
12:29 I always like to make sure that their heart is strong
12:31 and make sure they don't have anything like a thyroid
12:34 or anemia or that kind of stuff, but it is going to be
12:37 a big issue because I think this world is going
12:40 to have some major changes coming up.
12:41 Yeah, I think we are all witnessing that everyday.
12:44 The next question, we might have to get back after a break
12:47 because we have a break coming in about one minute Dave.
12:51 One of the things I wanted to talk to you about is as an
12:54 Electrophysiologist and as far as our country,
12:58 we can talk about this more.
12:59 Are we going to be able to keep up financially with our
13:03 technology, you know technology is growing and the
13:07 population is aging, are we going to be able to keep up
13:09 with this and is there a balance?
13:11 That's a great question, I don't have the answer to that.
13:14 There is no answers to that when I am afraid.
13:16 While I hope you're enjoying Dr. Wendt explanations about
13:19 electrophysiology and we are going to be talking more
13:22 about this and answer your questions but I want to invite
13:25 you to remember you can always get a hold of us by going to the
13:28 website: heartWiseMinistry. org or if you don't
13:31 have a computer and want to write us write us at:
13:36 Heart Wise Ministries, P.O. Box 80 Ooltewah TN 37363
13:40 and we will try to get your questions answered.
13:42 But before we go to break, one of the things we have
13:45 been emphasizing this year our program is at the heart of
13:48 health is indeed love, and one of the treatments
13:51 for almost for every condition that we can have is love.
13:53 So if you don't have a Little love in your life, get a
13:56 dog or cat or go out and give someone a hug or a kiss
13:59 today and you will improve your chemistry
14:01 just a little bit.
14:02 We will be right back after this short break.