Joey Wahler (Host): Does your heartbeat feel irregular?
You could be experiencing a problem with its electrical system, which sends
signals through your cells to regulate heart rate and rhythm. If untreated,
these irregular heartbeats known as arrhythmias could lead to stroke and heart
attack. So, we're discussing causes of irregular heart rhythms and new advances
helping patients get back on their feet. Our guest, Dr. Thomas Turnage, he's a
cardiac electrophysiologist with Infirmary Health's Diagnostic and Medical
Clinic.

Host: This is LIFE Cast, a podcast from Infirmary
Health. Thanks for listening. I'm Joey Wahler. Hi there, Dr. Turnage. Thanks
for joining us.

Dr. Thomas Turnage: Sure. Good morning.

Host: Good day to you. So first, for those unaware, what
exactly does an electrophysiologist do?

Dr. Thomas Turnage: Well, an electrophysiologist is a
cardiologist who specialize in the electrical system of the heart, managing all
sorts of arrhythmias from slow heart rhythms to fast heart rhythms.

Host: Do you figure there are many people out there that
don't even know that there are electrical systems involved with their heart?

Dr. Thomas Turnage: I think there's a good proportion of
people who don't.

Host: But that's why you went to medical school, right?
So, what exactly is an irregular heartbeat or arrhythmia?

Dr. Thomas Turnage: So, an irregular heartbeat can mean
several different things. An arrhythmia, it just means any sort of rhythm of
the heart that is out of normal from what is sinus rhythm or the normal rhythm
of the heart. That can be from anything from extra beats or extra premature
contractions from either the atrium or the ventricles or other arrhythmias such
as atrial fibrillation or ventricular tachycardias.

Host: And so, what are the most common causes of this,
the conditions where irregular heartbeats are symptoms of that,

Dr. Thomas Turnage: Well, often it's obesity. Sleep
apnea is a number one contributor to the development of atrial fibrillation,
alcohol, stress and ischemic heart disease.

Host: Okay. So, you're mentioning a number of factors
there that would be self-inflicted, so to speak. So, how much control do we
have ourselves of not being at risk of having this occur?

Dr. Thomas Turnage: Sometimes we're just genetically
predisposed to develop these abnormalities of the electrical system. But there
are things that patients can do to limit their risks, such as avoiding excess
alcohol, obviously smoking, to avoid ischemic heart disease, try to manage
stress as best as they can, try to manage their weight and exercise pretty
routinely.

Host: And so if the conditions remain untreated, what
are some of the negative effects that can result?

Dr. Thomas Turnage: Well, that varies pretty widely
based upon the arrhythmia that one patient may have. But for instance, if atrial
fibrillation is left untreated or undiagnosed, it's a major risk factor for
stroke. Whereas if you have something like ventricular tachycardia, that could
ultimately lead to death.

Host: And stroke, if I'm not mistaken, is one of the
leading causes of death in the country, right?

Dr. Thomas Turnage: It is indeed. Yep.

Host: So, how do you treat these conditions?

Dr. Thomas Turnage: Well, we use a wide variety of
tools. For instance, if you have slow arrhythmias where there's a block in the
conduction system of the heart, we can put in pacemakers. If you have faster
arrhythmias such as atrial fibrillation or atrial flutter, we can use
medications such as arrhythmic medications, as well as blood thinners to reduce
your risk of stroke. And ultimately, there are minimally invasive procedures
called ablations, which can target these fast arrhythmias.

Host: So, can you tell us about how some new advances in
technology that support the heart's electrical system are helping patients
reach healthy heart rhythms?

Dr. Thomas Turnage: Electrophysiology is a very, very
advancing field. It's out on the forefront of biomedical engineering from new
advances in pacemakers to where they're no longer requiring leads, they're
being implanted just straight in the heart with pacemakers, maybe about the
size of three or four maybe rice pellets. The ablations use all sorts of
things, including systems like GPS to create an electroanatomic map of your
heart, target the area that is responsible for the rhythm, and then able to use
a catheter which can deliver a radiofrequency energy to hopefully cut off that
area from the heart from causing that rhythm.

Host: And so, it sounds like for one thing, having a
pacemaker nowadays is a lot more, for lack of a better term, convenient than it
was years ago, right?

Dr. Thomas Turnage: Oh, it's much more convenient. Even
the more traditional transvenous devices are smaller, they're safer, the leads
are more dependable. But as we kind of begin advancing into more leadless
pacemakers, the paradigm and the traditional approach to delivering these
intracardiac devices is going to shift rapidly.

Host: I understand you're paving the way in the Gulf
Coast region for advanced interventional procedures like the left bundle pacing
technique. What does that involve?

Dr. Thomas Turnage: So, the left bundle is a group of
tissues in the heart that is specialized in rapid conduction of the heart, and
it's utilized in the normal electrical cycle of the heart. And so, there is a
technique that's been newly developed where you attempt to try to engage the
left bundle tissue with one of these leads, such that when the pacemaker
delivers an impulse, it actually delivers an impulse within the left bundle to
take advantage of the native conduction system of the heart.

Host: And so, what about the fact that there are
obviously many people living with an irregular heartbeat that are subject to
one of the treatments you just covered. How common is it to have an irregular
heartbeat?

Dr. Thomas Turnage: It's very common. There are some
estimates that say about 30% of the baby boomer generation will develop atrial
fibrillation at least once in their lifetime.

Host: Wow. I mean, that's an eye-opening figure, no?

Dr. Thomas Turnage: It is. It is.

Host: And so, how does that compare? I mean, is that
much greater than it was, say, 10 or 20 years ago?

Dr. Thomas Turnage: Well, I'm not necessarily sure to be
quite honest with you, but I think we're getting better at detecting it. We
have better modalities to pick it up and we, as physicians and cardiologists
and nurse practitioners, are being more and more suspicious of patients who
come in with diagnoses such as unidentified strokes and we're looking more and
more for arrhythmias as a cause of these issues. So, I'm not sure that it's
occurring more frequently, but maybe we're picking it up a lot more.

Host: Let me ask you this. Do people, in your view,
people in general that is, get their heart checked on enough of a regular
basis?

Dr. Thomas Turnage: Probably not, to be honest with you.
Detection should be probably started at a much earlier age than generally
people think in their late 60s and 70s. And oftentimes, you know, a heart
attack or an arrhythmia is the first time that they even are aware that there
might be a problem. So, I think general heart health and getting in with a good
primary medicine or internist physician can go a long way to screening you
towards these potential problems.

Host: And so, how often should you have your heart
checked to some degree? And at what age does that start, do you think?

Dr. Thomas Turnage: Well, I think that would vary based
upon your family's history. Certainly by the age of, you know, 40 or 45, you
should probably be seeing a physician annually, probably even earlier than
that, 30, 35, just to touch base with them and make sure everything else with
your cholesterol and lipid panel look okay and maybe have a baseline EKG at
that point, just to provide some bit of screening going forward and then risk
stratify yourself based upon your family's history and your other risk factors.

Host: Because I know I'll hear sometimes about people in
the news, whether it's well-known people, et cetera, who succumb to a heart
attack or some kind of a serious blockage when it just comes on all of a
sudden, they're not necessarily that old and there were no warning signs. And I
would imagine much of the time something like that can be headed off at the
pass if only they had been checked on a more regular basis, right?

Dr. Thomas Turnage: Well, that can be sort of tricky.
You're sort of talking more about the plumbing system of the heart, the
interventional aspect of it. Oftentimes they tie with the electrical system,
but not always. And there's not always a red flag or red herring to be had.
Screening should really be based upon a patient's risk factor such as smoking,
you know, obesity, sedentary lifestyles, as well as an early family history of
coronary disease. That should raise some suspicions, I think. Early detection
is always the goal, but even a more realistic or better goal would be
prevention in addressing those types of issues at an early age to develop
lifelong habits that could prevent the progression or development of blockages.

Host: Sure. And so, I was obviously talking there more
about general heart health overall, getting back to your specialty in order to
end on that note. In summary here, what's your message to those listening that
have an irregular heartbeat in terms of some of these advanced treatments that
are available nowadays and, most importantly, what they can look forward to in
terms of lifestyle once it's gotten under control.

Dr. Thomas Turnage: Sure. I think the message is if you
think you're experiencing an irregular heartbeat or palpitations, then you
should see a cardiologist or even an electrophysiologist who can accurately
diagnose what the exact issue or mechanism of the arrhythmia might be. There
are several types of arrhythmias and the therapeutic options available differs
depending on which particular arrhythmia patient has.

I think I would say to patients, there are treatments, there
are good treatments, there are good procedures, which have a goal of
eliminating these all together. And we're getting better and better at our
abilities to both diagnose and intervene on these patients with these
arrhythmias in a much safer and quicker way. After the arrhythmia is under control,
most patients can live a very normal life.

Host: Well, certainly great to hear. And folks, we trust
you're now more familiar with heart arrhythmias and their treatment. Dr. Thomas
Turnage, thanks so much again.

Dr. Thomas Turnage: Thank you for having me.

Host: And as the first choice for healthcare for the
Gulf Coast Region, Infirmary Health is here for you, here for Life. Infirmary
Health's Heart and Vascular Institute is comprised of physicians and
specialists across cardiology, cardiovascular, vascular and thoracic services.
An award-winning team providing some of the most comprehensive state-of-the-art
heart care available across the Gulf Coast Region. Please visit
infirmaryhealth.org to learn more about the Heart and Vascular Institute and to
find a physician near you. Now, if you found this podcast helpful, please share
it on your social media and thanks for listening to Life CAST, a podcast from
Infirmary Health. Hoping your health is good health. I'm Joey Wahler.