Hi, my name is Dr. Warrick Bishop and welcome to my podcast and videocast station. As always, I'm really grateful that you've taken a moment to tune in and I hope I can share something that you find interesting and valuable for your own health journey. Today, I'm really excited to be interviewing Jim. from New Hampshire in the US. We are on different time zones. We're not in the same studio, but Jim is a young individual who has a lived AF experience. He's written a book about it, and that book is called Unlimited Heart, How to Transform Your Pain into Purpose. Welcome, Jim. Thank you, Dr. Org. I appreciate your time today. Look, I really appreciate you reaching out and giving me the opportunity to share what's incredibly important, and that is people sharing their experience to help other people who are going through the process. So just by way of background, I understand you have a science degree. Maybe talk a little bit about what your background is, and then we'll talk about how AF impacted you. Sure. No, absolutely. Thank you. a degree in biology and biology education because I wanted to follow in my mother's footsteps and be a teacher. But that didn't work out well in our school systems here. So I jumped into the corporate training. And so I got into the life sciences industry here in the United States. And I was always involved in learning and development for most of my career. And with that, I worked in a whole variety of different disease states, cardiac, oncology, primary care, you name it. And then in 2012, I went out and I started my own business to build my own learning and performance company to build corporate training materials for pharmaceutical and biotech companies. And it was at that same time that I was launching my business in 2012 that I was also diagnosed at the ripe old age of 38 with atrial fibrillation. And so my entrepreneurship, as well as my AFib journey, have been entangled ever since. And so that's the whole reason around writing the book. And my purpose right now in life is try to help some folks that are also suffering the same fate that I've had. Well, we know the condition is incredibly common, but at 38 years of age, you're an outlier. experience social fibrillation here in Australia, you'd be aware that the condition impacts about 1% of the population, about 15% of the population over 80 years of age, and probably 300,000 to 400,000 Australians. I'm guessing apart from the absolute numbers there, they're similar sort of figures in the States, Jim? Yeah. Yeah. So I think with the raw numbers, we're sitting at around 6 million patients in the U.S. on an annual basis. And that's going to grow up to 12 million come 2030. So we're not we're six years away from that. And we're going to double the amount of prevalence of it. And so it's it's an issue. And, you know, you brought up earlier, you know, that I was young and I and I was young. And it's what's intriguing for me, too, was I was a rower in college. And I actually had suffered some of my AFib experiences while I was rowing. I didn't know what it was at the time. For me, I was, you know, 20, 22 years old. So I just assumed maybe I had a few too many pints the night before my rowing practice. And so my heart was just making up for it. But, you know, of course I ignored it. And once the exercise and the intensive training with my rowing program went away, the AFib kind of subsided. And then it reared its ugly head again when I was 38. So, Jim, a lot of this is about trying to understand that patient journey. If you weren't aware of it as a younger man and it sort of fitted in with your thoughts around your own exercise training, then it obviously didn't impact you too much at all. But as a 38-year-old, how did AF impact you? What were the things that really, well, what were the symptoms you suffered? Yeah, right. So and these these ones came on pretty quickly and aggressively. I felt some palpitations right out of the gate. But again, you know, I was starting a business. So was it anxiety? Was there something else going on? But the biggest challenges for me was when I was starting to get up in the middle of the night, going to the bathroom, finding myself really clinging to my bed, to my dresser, to the bathroom, to the sink, trying to get there. I'm thinking to myself, why am I so dizzy? Why do I feel like I'm going to pass out? And here that was really my AFib kind of rearing its head for me. And it wasn't until I woke up one morning and I went down like a tree and my wife screamed out, did you just pass out? And I'm like, I did. And that was the beginning of me going in to get checked out to see what was going on because I can't say that I was ignoring it, but I was like. I'm 38, like what's going on, right? And so that was the beginning of me understanding that I was at that time diagnosed with paroxysmal atrial fibrillation. So we often, certainly when I see a patient who has atrial fibrillation and particularly if it's early, we're often asking what might've been the trigger. And for those listening, atrial fibrillation is... often the final common pathway of multiple insults, and they can be different. One of the most common insults is age, which is why it increases as people age. But atrial fibrillation can be triggered by alcohol, stress, infection, major surgery. So we're often wondering what may have triggered it. For you, Jim, was there something that became clear? Nothing truly clear. I think it honestly, it might've just been related to the stress with starting the business. And then also I think I, you know, and there's obviously the familial connection. You know, we don't, we're not determined that anybody in my family had it. We think my father might've had it. He had ultimately, he had vascular dementia and we know the correlation between if you have AFib, it increases the risk for having dementia as well. And so for me, it was, There was no true trigger. It just it just reared its ugly head one day and I started not feeling well. But to your point about alcohol, I certainly noticed if I had a pint or some sort of mixed drink that my heart would immediately react to it. And so that's when I started to stop drinking. And then I realized that it would it would go away over time. So alcohol is a very powerful trigger, but for those listening and I know there'll be some. older athletes in the mix listening. And for those who are curious, there is an association between high levels of exercise and atrial fibrillation. And I'm not sure if this ties in with being a rower, potentially it could, Jim. And we are starting to see individuals who undertake, you know. excessive I guess or extreme exercise particularly endurance exercise and now we're particularly matching up those people who have done a lot of exercise with specific gene markers and finding increased risk of atrial fibrillation so it as we were talking about is probably a combination of a number of things. Yeah, and I'm blessed. I'm also six foot six. So, you know, the propensity of, you know, if you're tall and you're a rower, what I've read as well, that increases the chance of, you know, getting AFib. Yeah, absolutely. And I'm not sure what it's all about other than potentially some inflammation that's occurring in the atria, but it's an area that's really... Full of research right at the moment. Our understanding is growing all the time. Particularly that space of the athlete's heart is a fascinating area. But back to you, Jim. When you had this atrial fibrillation, how was that managed? Yeah. So right out of the gate, they, they try to do it, um, medicinally, you know, so they put me on a, um, you know, a beta blocker. And for me, the beta blocker did not work well. Um, it actually suppressed my heart rate so low that I felt like I was going to pass out all the time, um, had no stamina whatsoever. So they switched me out of the bed beta blocker and then switched me to a calcium channel blocker, like a Diltiazem or a Cartazem. And that I had no reaction to, and that actually worked well for me for a little while. And then eventually the proxismals shifted into persistent AFib. And then I ultimately received my first cardiac ablation probably within about a year and a half of my diagnosis. Okay. So for those listening, beta blockers are the agents that we use to... turn down the sympathetic nervous system. We've got a fight and flight nervous system. That's the sympathetic nervous system. And we've got a rest and digest nervous system. That's the parasympathetic nervous system. And beta blockers turn down that fight and flight. Often in younger individuals like yourself, Jim, they knock people around and they feel pretty flat. So it's often trial and error to see how people respond to these medications. When you had your ablation, how effective was that? So it worked well. It worked well for a short stint, right? And as you know, being a cardiologist and my electrophysiologist to me, he's like, well, we think we fixed your AFib. Don't be surprised if maybe an AFlutter comes out of this. So atrial flutter. And lo and behold, it would be probably like two weeks post my procedure is when my atrial flutter then presented itself. And so then I went in for a cardioversion. And that was done probably about two months after my ablation. And once that was complete, my heart was reset from the cardioversion. I was in normal rhythm for probably about six to nine months. Okay. For those wondering, atrial flutter is a more organized rhythm occurring within the atria. And the atria, instead of being chaotic, which is what atrial fibrillation is, complete loss of synchrony of the atria, which is atrial fibrillation. It's all twitching, fibrillating. Atrial flutter is an organized rhythm, but it runs at about 300 beats a minute, which is a bit too fast. And those two, as Jim just indicated, can have an interplay, and that's obviously what happened for you. So nine-odd months in, was it AF that came back or flutter? So it was AF that came back. And so invariably, and what my electrophysiologist did something I thought was unique and I was treated at Dartmouth and he actually ablated the entire backside of my heart, not around each of the pulmonary veins. So he felt less scar tissue and everything else. So that worked well, but there was just a little bit of a pinprick. So then everything rewired itself. And so the AFib presented itself again. And then it came back and I was dealing with that a little bit, but then it became a little bit more aggressive and I ultimately shifted into Tacky Brady syndrome. And that lasted for, and I was dealing with that for close to six months. And I was, my heart was pausing. I didn't know this, of course. I just thought I was dealing with my AFib in general, but my heart was pausing close to 32 times every two weeks for about six seconds. And so again, I didn't know, didn't know what was, I just assumed, Hey, this is my AFib. It's pretty bad, but I'm managing it. I thought, you know, you know, that that's the public service announcement is like. If you feel like you're passing out, something's probably not good. So get checked out. So here I was, and eventually they put me on a cardiac monitor and presented again to my electrophysiologist. And he said, you have tacky Brady. This is not good. We're putting a pacemaker in you tomorrow. And that was done, done, done, and done. Those episodes of pauses, Jim, for you, were you in sinus rhythm at the time you were pausing or were you in atrial fibrillation at the time you were pausing? Yeah, I was in persistent AFib. Yeah. Okay. Wow. And Tacky-Brady syndrome is pretty uncommon for atrial fibrillation. Was there any thoughts as to what may have driven that? No, I think he had stated... And I think this goes along and I'm not saying it's correlated now with the exercise heart, right? He just said, your heart just got so comfortable with being at the persistent AFib for so long that it just was getting tired. And so that's where the pause came in and then it would reboot itself, right? And so... He didn't have any direct correlation with that, but he did ultimately know that that little pinprick was an issue. Once they fixed that, I've been now AFib free since 2019. So it's been a solid five years. So you're in normal sinus rhythm. supported by a pacemaker at the moment. Is that correct? Pacemaker is just a nice little thing that my insurance company reminds me every month that I have to pay a bill that they're tracking me. But no, pacemaker is just in there for security, but it does nothing because I'm in complete normal rhythm. Well, that's a good outcome then, isn't it? It's a great outcome. Yes, I feel awesome. Yeah. Okay. Well, that's your journey. And that's been the case for how many years, did you say? I've been... Clean of AFib for five years now. Yeah, okay. Well, that's a good story. And the structure of your heart? So the structure of my heart at this point? So the reason I'm asking this for those listening or watching, the reason I'm asking is that we can sometimes see if the heart's in atrial fibrillation and driving the ventricle, the main pumping chamber, too quickly for too long, that the ventricle can decompensate. and enlarge and not be working properly. So the structure of the heart becomes really important in our assessment and then ongoing management of an individual who's got atrial fibrillation that may impact the left ventricle function. Did you have any issues there, Jim? None of that was raised with me. So I'm assuming all of that was still normal. Yeah. Okay. Well, look, we've covered probably 10 to 15 minutes, which is sort of the standard time I try and run my interviews. We've still got lots to talk about. I think if it's all right with you, we might wrap up. This would be the end of part one with Jim Caveney. And what I'd really like to do is come back and really talk more about your lived experience and how that impacted you emotionally. And then talk more about what your... plans are and what your objectives are with Unlimited Health, which is the company you're putting together to support people as well. So, Jim, thank you so much for joining me. Thank you. Enjoy the day. For those listening, I bet there's a few people out there with atrial fibrillation. I'm sure you can relate. What I will mention, just as a complete aside, is that I'm also an AF sufferer. I'm not in AF at the moment, but I had open heart surgery two years ago and in the post-operative period, felt my heart go at a rhythm. Indeed, it was atrial fibrillation and open heart surgery and particularly, yeah, particularly cardiothoracic surgery is linked to atrial fibrillation. That resolved, but I've subsequently had a... closure device in my left atrium. That's also associated with atrial fibrillation. So I've had a couple of procedural related atrial fibrillation. So I'm not new to this rodeo myself, but we're going to share Jim's story when we come back. For those listening, really appreciate you tuning in. If you've got any queries or questions, drop us a note for now. I hope you live as well as possible for as long as possible. And please make sure you tune in for part two. Goodbye.
