Speaker 1: Hi everyone.
Speaker 2: It's me James today and I'm joined by Glen Pyle,
Speaker 2: who's a professor of molecular cardiology and a member of
Speaker 2: the IMPART Network at Dalhousie Medicine.
Speaker 1: Glenn, thank you so much for joining us.
Speaker 2: Can you is there is there anything I missed out
Speaker 2: first of all in your bio there that might be
Speaker 2: relevant for people.
Speaker 3: No, I think that's a short and sweet I don't
Speaker 3: need all the details for.
Speaker 1: Sure, Thank you.
Speaker 3: Yeah.
Speaker 2: So, what we're here to talk about today is these
Speaker 2: sudden the phenomenal I suppose of sudden cardiac arrest specifically
Speaker 2: like in young people and young athletes, because as many
Speaker 2: of you will have been aware, this has been increasingly
Speaker 2: an area in which anti vaxxers and conspiracy theorists have
Speaker 2: been trying to leverage what is an unfortunate but not
Speaker 2: unprecedented cardiac arrest, like in this case, most recently Bronnie James,
Speaker 2: but it has happened before in the number of sports,
Speaker 2: and they've been trying to leverage us as of quote
Speaker 2: unquote like prove for evidence that the vaccines are killing
Speaker 2: otherwise healthy young people, which is nonsense. And I can
Speaker 2: tell you it's nonsense. But someone who can tell you
Speaker 2: from much more informed perspective is Glenn. So Glenn, can
Speaker 2: we start out by maybe talking about like how common
Speaker 2: this sudden cardiac arrest in young athletes is and what
Speaker 2: we might what hypothetes we might have to what caused it.
Speaker 3: Well, I mean, first of all, we look more broadly,
Speaker 3: it's very common. I'm from Canada and we have about
Speaker 3: thirty five thousand of these every year within young athletes.
Speaker 3: The data out of the US says that about two
Speaker 3: thousand die every year from sudden cardiac arrest, and two
Speaker 3: thirds of these young people do so during some sort
Speaker 3: of exercise or sporting event. So in the grand scheme
Speaker 3: of things, when you have a country of several hundred
Speaker 3: million people, a thousand or so that's like that is
Speaker 3: but proportion relatively small. But we've known about this for
Speaker 3: a long time and these numbers actually really haven't changed
Speaker 3: very much in decades.
Speaker 2: Okay, So yeah, there's obviously been a particularly increase due
Speaker 2: to COVID vaccinations, because they're unrelated. I wonder actually it's evidence.
Speaker 2: I think I've read some stuff that having COVID or
Speaker 2: having had COVID multiple times might increase your risk for
Speaker 2: cardiac arrest.
Speaker 1: Is that true?
Speaker 3: Yeah, so broadly, So they haven't looked specifically at cardiac
Speaker 3: arrests because cardiac arrests typically is in a lot of
Speaker 3: times the end result of a number of different conditions
Speaker 3: of cardiac arrhythmias are known to be increased. A patone
Speaker 3: study showed that. But I guess the year and a
Speaker 3: half ago by now, certainly early in the pandemic, one
Speaker 3: of the first signs we were seeing people who are
Speaker 3: being infected were having heart attacks, developing heart failure, these things,
Speaker 3: and in cardiac arrest the most common cause or cardiac
Speaker 3: are with Yes, the tone study showed And every time
Speaker 3: I talk about this, I have to go back and
Speaker 3: look because the increase was several hundredfold after COVID, and
Speaker 3: so I have never really seen anything like that before.
Speaker 3: So arrhythmias are relatively common in terms in the world
Speaker 3: of cardiovascular disease, and the fact that COVID the infection,
Speaker 3: actually increases it. But the vaccines do not means that
Speaker 3: the risk for some cardiac death really would be highest
Speaker 3: amongst those who are infected, not those who get vaccines.
Speaker 2: Okay, do you know offhand if like when we have
Speaker 2: that maybe this was too early in the pandemic to
Speaker 2: tell like that that risk that comes with having COVID
Speaker 2: right for having rhythmia afterwards, is that risk mitigated by
Speaker 2: if you're vaccinated and then you get COVID.
Speaker 3: So yes, there's been some more recent studies because obviously
Speaker 3: early in the pandemic, when we didn't have the vaccines,
Speaker 3: we couldn't answer that. And then early after vaccines were
Speaker 3: looking at things like infections, and some of these cardiac
Speaker 3: issues may not arise until even after the infection is clear.
Speaker 3: So we see that in people with long COVID, for example,
Speaker 3: krdiac issues are most common. And so we've seen in
Speaker 3: some recent studies that people who are didn't even what
Speaker 3: they described as partially vaccinated, so one or two doses,
Speaker 3: had a reduced risk of what we call MACE, which
Speaker 3: is a major adverse cardiovascular event. And so that's an
Speaker 3: all encompassing term, which would be things like stroke, heart attack,
Speaker 3: you know, things things like that, those major cardiac events.
Speaker 3: That's data has come out earlier this year, within the
Speaker 3: last year, a couple of studies.
Speaker 2: Okay, so circling back to those cardiac arrests and I
Speaker 2: guess wrote more broadly at cardiac issues in young people
Speaker 2: and fitting young athletes. It's something I'm familiar with with
Speaker 2: a background in cycling. Like I've known people die of
Speaker 2: cardiac arrests who otherwise extremely fit. No, I wouldn't necessarily
Speaker 2: say like sometimes being fit and being healthy are not
Speaker 2: the same thing. Certainly the very like point to end
Speaker 2: of indurance sport. I think the fittest people are not
Speaker 2: necessarily the healthiest, but very fit sometimes very healthy people
Speaker 2: have friends of mine have had these issues. Is in
Speaker 2: those cases we might not know? I don't know is
Speaker 2: being an athlete like increasing someone's chance of having those
Speaker 2: cardiac arrests or is it that they have some kind
Speaker 2: of pre existing condition that's just that's just been underlying
Speaker 2: for a while.
Speaker 3: Yeah, that's a good question. What we do know in
Speaker 3: this This is all data from pre COVID, so it's
Speaker 3: not something that's been impacted by the panamic or vaccines.
Speaker 3: We do know that the rate of sudden cardiac death
Speaker 3: and the general population is about one in one hundred thousand,
Speaker 3: and that in athletes, which is a very broad term,
Speaker 3: and we can get into that. How to we do
Speaker 3: find an athlete and things like that is anywhere from
Speaker 3: two to four times the rate that that's groups of
Speaker 3: athletes subsections are actually higher, so we know the radius
Speaker 3: higher in these athletes, typically these high performance athletes. You
Speaker 3: know why that is, It's an interesting question. It could
Speaker 3: be the training, for example, puts a stressor on them.
Speaker 3: So they may have a pre existing condition. They may
Speaker 3: have a cardiac orithm of like long QT syndrome or
Speaker 3: even something called hypertrophic cardiomopathy. Sometimes they know about it
Speaker 3: and sometimes they don't, and then the training on top
Speaker 3: is enough of a trigger. So one of the examples
Speaker 3: I use in my class is Anthony Evenlows, a soccer player.
Speaker 3: I believe it was in the Netherlands. He was playing.
Speaker 3: He had a known cardiovascular condition, so he had what's
Speaker 3: called it ICD or on planet cardiodefibrillator while he was playing,
Speaker 3: and he suffered some cardiac death on the on the field.
Speaker 3: There's actually video of it, and that shocked him back
Speaker 3: into rhythm. So you know, some of these people may
Speaker 3: not know and discover in the course of training, and
Speaker 3: some may know and opt to take that risk anyway,
Speaker 3: and then it's the training that or the competition that
Speaker 3: brings it out.
Speaker 1: Yeah, okay, yeah, yeah.
Speaker 2: I have a very good friend with ICD and it's
Speaker 2: certainly been at the end of a very difficult process
Speaker 2: for him to have that, and that involved lots of
Speaker 2: lifestyle changes. And so when we let's what exactly is
Speaker 2: an athlete in these studies, like, is that somebody goes
Speaker 2: to gym twice a week? Is it someone putting in
Speaker 2: twenty hours on the bike, like what?
Speaker 3: So, most of the studies that we're talking about, so
Speaker 3: I assume we're not talking about the people who are
Speaker 3: claiming that the vaccines are to athletes because they have
Speaker 3: a very different definition. I can talk about that most
Speaker 3: of these studies that we're dealing with, where we get
Speaker 3: these rates that are two to four times higher than
Speaker 3: the general population or what they refer to as competitive athletes.
Speaker 3: So for people in the US, these would be your
Speaker 3: NCAAA or college athletes. Some of them are professional athletes,
Speaker 3: you know, soccer players and the you know, the British
Speaker 3: League and things like that. So these are people who
Speaker 3: play at a at a competitive level. Oftentimes they're they're
Speaker 3: making a living. I mean, you can argue whether college
Speaker 3: athletes are making a living out of this, but there's
Speaker 3: there's some high level of competition in these athletes. That's
Speaker 3: generally the people that were that these studies are based on,
Speaker 3: not the guy who goes to the gym twice a
Speaker 3: week or something like that.
Speaker 1: Okay, yeah, yeah, so fairly elite.
Speaker 2: And what is it that you were saying that's different
Speaker 2: from the claims that these anti vax people or vaccine
Speaker 2: skeptics or whatever, you know, people who want to say
Speaker 2: that vaccines are getting people which isn't true. What sort
Speaker 2: of the definition that they're using or what's the claim
Speaker 2: that they're making.
Speaker 3: I guess, well, they really don't have a definition, is
Speaker 3: the problem. So they'll use the term athletes. And I
Speaker 3: think most people, you know, maybe maybe you don't see
Speaker 3: an athlete as necessarily being a college or professional level.
Speaker 3: It could be like a high school athlete who's competing
Speaker 3: you know, once or twice a week or whatever. And
Speaker 3: that's that's fair. But when you look at the lists
Speaker 3: that they have, I mean, I've talked about this recently
Speaker 3: and the Died Suddenly movie documentary, whatever you want to
Speaker 3: call it. The list of people that they have on there.
Speaker 3: For example, they have musicians, they have a Thai princess
Speaker 3: on the princess from Thailand on there, and they also
Speaker 3: have people who died of cancer, someone who got an
Speaker 3: eye injury. So I'm not really sure, first of all,
Speaker 3: what their definition of athlete is. I'm not sure what
Speaker 3: their definition of sudden cardiac death is. When you have
Speaker 3: people dying of cancer or suffering an eye injury like that,
Speaker 3: those are not related at all. There was an earlier list.
Speaker 3: I think it's related to the Good Sciencing. I wrote
Speaker 3: about this probably a year or so ago. I went
Speaker 3: through the list of people that they had on at
Speaker 3: the time. There was about one hundred, just a little
Speaker 3: over one hundred people that they claimed and died. There
Speaker 3: were soccer referees on there. There were retired athletes, there
Speaker 3: were people. One guy was out for a hike he
Speaker 3: was listed there. Now, you could argue a soccer referee
Speaker 3: is athletic, certainly, you know, running around the pitch and
Speaker 3: doing that. I could see that. But that person died
Speaker 3: at home in their sleep, not in competition. The retired
Speaker 3: soccer player had been retired for six or seven years.
Speaker 3: So even in the cases where they have athletes, they're
Speaker 3: really stretching what we would define as an athlete.
Speaker 2: Right, Yeah, I wonder is it data to show that,
Speaker 2: like overall mortality is lower in people who are vaccinated
Speaker 2: than unvaccinated, Like that exists yet?
Speaker 3: Yeah, so that's what some of these studies that I
Speaker 3: talked about that were done earlier this this year, there
Speaker 3: was a it was a Jack study the journal American
Speaker 3: College of Cardiology showed that even people who are partially vaccinated,
Speaker 3: there's a reduction in these cardivocular complications. And the Gama
Speaker 3: study which was done earlier specifically focused on am I.
Speaker 3: So the heart attacks at cute my cardinal functions and
Speaker 3: stroke also lower risk.
Speaker 2: You were saying earlier that there might be some sports
Speaker 2: that that had even higher rates than those those ones
Speaker 2: you mentioned overall for athletes.
Speaker 1: What sport to those?
Speaker 3: Yeah, so the one that's bit'sman raised recently is basketball.
Speaker 3: They were at least in some of these studies done
Speaker 3: in the US, much higher than other sports. Yeah. So,
Speaker 3: I mean, you know, basketball is can be an aerobic
Speaker 3: event and that you're running back and forth, you know,
Speaker 3: up and down the court quite frequently, but it's punctuated
Speaker 3: by these bursts of of you know, sprints and things
Speaker 3: like that, which some have speculated that might kind of
Speaker 3: be the issue, right, that you don't settle into just
Speaker 3: a simple rhythm. I'll say simple rhythm, like you know,
Speaker 3: like riding a bike is. It's not it's obviously simple
Speaker 3: as as you describe it, but at least potentially there
Speaker 3: there's periods of time when you can sort of get
Speaker 3: into a rhythm and stay there. And here it's it's
Speaker 3: rest periods punctuated by these rapid bursts. And so there's
Speaker 3: the possibility that that may be related.
Speaker 2: There, okay, and so that that might be why that
Speaker 2: there are higher death rates to there.
Speaker 3: It's possible. Yeah, they're not sure why these things happen
Speaker 3: to specific.
Speaker 1: Sports, Okay.
Speaker 2: Our our friends in the anti vax community show in
Speaker 2: their own minds why these happened, Like do they have
Speaker 2: some kind of hypothesis they're advancing.
Speaker 3: Uh no, So that's a good point. They'll say it's
Speaker 3: the spike protein. I'm sure I've heard that race before,
Speaker 3: but they don't really explain beyond that. It's interesting about
Speaker 3: the spike protein in the vaccines, as it's been modified
Speaker 3: to not be active, and so you have the spike
Speaker 3: protein in the virus which causes injury and yet they
Speaker 3: don't seem to, you know, acknowledge that that could cause
Speaker 3: these these issues. And yet the spike protein in the vaccine,
Speaker 3: which has been designed to limit that injury, somehow overcomes
Speaker 3: that and actually causes the injury that's not associated with
Speaker 3: the the infect like, like not that it makes sense, right,
Speaker 3: You have to work live in these parallel worlds that
Speaker 3: don't don't ever.
Speaker 2: Mix, right, Yeah, so they yeah, they're suggesting that this protein,
Speaker 2: which is a modified version of the one that's already
Speaker 2: in the virus but it's non harmful with one of
Speaker 2: the virus, is harmful. It's because of the modification.
Speaker 3: Yeah, Certainly a good number of people who don't like
Speaker 3: the vaccines also claim that covid itself is really not
Speaker 3: much of a threat. And then so again I don't,
Speaker 3: I don't. I don't see how they can reconcile these
Speaker 3: these points, right, especially when you're arguing about the same protein,
Speaker 3: one of which has been modified to be less active,
Speaker 3: and yet you're saying the less active one is actually
Speaker 3: more dangerous than it Just doesn't make.
Speaker 2: Any sense, right, Yeah, And I think it's kind of
Speaker 2: not Uh. People may be come to it with with
Speaker 2: a sort of predetermined desire to conclude that the vaccine
Speaker 2: is dangerous, and I wonder, like I'm familiar with exerting
Speaker 2: cardiac death from my time cycling, and I remember in
Speaker 2: the early two thousands, there was this idea that people
Speaker 2: were dying because their blood had turned like quote I'm
Speaker 2: quoting from like newspaper articles at the time, too treacle
Speaker 2: and had become so thick that their heart couldn't pump
Speaker 2: it anymore, and that this was causing people to die,
Speaker 2: and the reason that they died was because they were
Speaker 2: taking excessive amounts of blood boosters like EPO or exog
Speaker 2: a CPO, and so I this wasn't true, at least
Speaker 2: to my knowledge. I don't think any of these people
Speaker 2: had tested positive. None of them had like autopsies that
Speaker 2: suggested that this is why they had died. But it
Speaker 2: seems to me that there's this natural desire to try
Speaker 2: and explain away these deaths of what people who are
Speaker 2: at the peak of their physical lives right people in
Speaker 2: their in their teens and twenties, are extremely fit, who
Speaker 2: we can see doing amazing things, and doesn't sort of
Speaker 2: line up for us when they die. It doesn't end
Speaker 2: up with what we think a healthy person is, and
Speaker 2: what we think a cardiac patient is, and and and
Speaker 2: so it seems to me that we create these explanations.
Speaker 2: Is that something you've seen in other areas before the
Speaker 2: COVID vaccine without either sort of conspiracies or just ways
Speaker 2: to try and explain this away.
Speaker 3: I don't know about conspiracy. I mean I think people
Speaker 3: understandably have a hard time reconciling what you just said. Right,
Speaker 3: you have belite cyclists or whatever sport it is. I mean,
Speaker 3: cycling is good because aerobically they have to be very fit,
Speaker 3: and then they die potentially of a cardiac condition. Right,
Speaker 3: So that makes no sense, you know. So the easiest thing,
Speaker 3: like you said, is to well, they must be doping,
Speaker 3: they must be taking steroids and you know, something that's
Speaker 3: going to harm your body. And so that has to
Speaker 3: be the explanation because it's it's it's easy. That's a
Speaker 3: simple way to get to this. The reality is that
Speaker 3: a good number of these people have underlying cardiac conditions.
Speaker 3: Not again, I don't necessarily mean a lot of cyclists
Speaker 3: have that. What I mean is the people who have
Speaker 3: these sudden cardiac deaths have undiagnosed cardiac conditions long QT.
Speaker 3: There's a condition called CPVT, you know, something like that,
Speaker 3: and so they're relatively i'll say benign. CPVT isn't necessarily
Speaker 3: but it's triggered. These things are triggered by stressful events
Speaker 3: like exercise and things like that. And so they may
Speaker 3: live a good part of their life in it to
Speaker 3: be in our seemingly in good health, and then the
Speaker 3: first sign for any of these people is death. That's
Speaker 3: the real challenge in dealing with with these these cases
Speaker 3: that lead to ser cardiac death, because that's the first symptom.
Speaker 3: People don't feel tired, they don't you know, have chest
Speaker 3: pains like having a heart attack or anything like that.
Speaker 3: It's simply something happens. The wiring goes off in the
Speaker 3: heart and you put the exercise on top of it,
Speaker 3: and they die. You know, it's not just these athletes.
Speaker 3: You'll have somebody who has a change in one of
Speaker 3: their genes. They're perfectly fine. Do they live into their
Speaker 3: sixties and then they suddenly die. Well, what allowed them
Speaker 3: to live sixty years with you know, no symptoms. We
Speaker 3: don't really know. But it's not uncommon that the first
Speaker 3: symptom is death and these people. So your friends there
Speaker 3: who you know, it's it's easiest to accuse them of
Speaker 3: doping because certainly we a lot of us talked about
Speaker 3: it at the time, as I'm sure you know you
Speaker 3: knew about it. There's no secret. So we connect those dots, right,
Speaker 3: we can see that, we can see that, let's connect them.
Speaker 3: We can't let's see long QT. So we don't know
Speaker 3: what long QT syndrome is. For a lot of people,
Speaker 3: it's hard to make that connection when you don't know.
Speaker 2: Yeah, and it's hard from the perspective of being Simone's
Speaker 2: friend or I can only imagine what it's like for
Speaker 2: their families to have this, Like I guess them be
Speaker 2: sort of liblef do they die, you know, or sort
Speaker 2: of a cue of something that they may in many
Speaker 2: cases I don't think did do It must be very
Speaker 2: difficult to deal with that on top of losing someone
Speaker 2: you love.
Speaker 3: Yeah. Well, and we're seeing that again here with the
Speaker 3: people who oppose the vaccines, which is either they're assuming
Speaker 3: things or they're speculating on things. And you know, unless
Speaker 3: you're in the circle of care, you don't know what's
Speaker 3: what's going on. So you know, you talked about Lebron
Speaker 3: James on here. You know, does he have an ununderlying condition?
Speaker 3: We don't know, and it you know, it's it's really
Speaker 3: not helpful for me to sit here and say, well,
Speaker 3: he could have long QT, he could have CpG bet
Speaker 3: like here, you know, to speculate like like that. I
Speaker 3: can talk about what are some things that lead to
Speaker 3: these these conditions generally in people, But I don't know
Speaker 3: anything about his health, and so it's not helpful for
Speaker 3: me to sit here and speculate on that while his
Speaker 3: family and then he himself is trying to you know,
Speaker 3: sort to get through that. That's you know, that's I'm
Speaker 3: sure that's upsetting for them. So I'm not sure why
Speaker 3: people feel the need to do that except to advance
Speaker 3: their own agenda.
Speaker 2: Right, Yes, yeah, I think that is the case. So
Speaker 2: let's talk a little bit about how we can I guess,
Speaker 2: mitigate these risks that exist. I remember when I remember
Speaker 2: when you're getting a license in Spain and they make
Speaker 2: you take a cardiac stress test there, like you get
Speaker 2: you ride your bike on a treadmill and they just
Speaker 2: ramp it up until your heart rates in the one
Speaker 2: nineties or whatever. And I don't know what they were doing,
Speaker 2: but they made us I think that may only have
Speaker 2: been for like elite athletes, but they made us all
Speaker 2: do that. Is that something where if there was an
Speaker 2: underlying one of these underlying risk factors that you mentioned,
Speaker 2: would would it be spotted on a test like that?
Speaker 3: Yeah, that's a little bit of a controversial area. So
Speaker 3: I noticed you said in Spain. In Europe, the consensus
Speaker 3: is that athletes need to go through these what we
Speaker 3: called pre screening. So you were probably yeah, probably had
Speaker 3: electrodes on your body. Yeah, yeah, And so that's a simple,
Speaker 3: non evasive test, and so you're right because some things
Speaker 3: you can pick up just rest, but some of these
Speaker 3: things don't appear until you stress the individual, and so
Speaker 3: they'll look for rhythm problems. The other test is what
Speaker 3: we call eco cardiography, which is basically an ultrasound of
Speaker 3: the heart, and there you can look at function, but
Speaker 3: you can also look at structure. Because there's a condition
Speaker 3: called hypertrophic cardiomopathy. It's relatively common in athletes, it's more
Speaker 3: common there, and that accounts for about fifty percent of
Speaker 3: these sudden cardiac deaths, and so you can pick that
Speaker 3: up on an ECG but you can also pick it
Speaker 3: up using ultrasounds. So if you scan the heart you
Speaker 3: see that it's very large, that would be a diagnosis.
Speaker 3: So first in Europe they do that. In North America
Speaker 3: and Canada and the United States they do not. The
Speaker 3: concern is there's a couple of concerns. One is the price,
Speaker 3: so you can you're screening large numbers of athletes to
Speaker 3: pick out a relative small number who may be affected.
Speaker 3: It's crude, but that is an argument that people make.
Speaker 3: So I guess the question comes down to how much
Speaker 3: is life worth to you and how much do you
Speaker 3: want to spend. So there is that, But there is
Speaker 3: another issue, which is what they call false positives. So
Speaker 3: you know, had you been diagnosed as having a condition,
Speaker 3: that you maybe pulled out of training for a little
Speaker 3: while while they do more tests and stuff like that,
Speaker 3: that could be very stressful on you. And so the
Speaker 3: view in North America's there's an unacceptably high number of
Speaker 3: those false positives and so they feel that it's not
Speaker 3: worth worth doing. The other issue, so I'm not sure
Speaker 3: when did you do this screening. Was it like twenty.
Speaker 1: Years or no, ten years ago? Probably like twenty ten.
Speaker 3: Yeah, So so one of the issues that we have
Speaker 3: is when you have these high performance athletes, their hearts change,
Speaker 3: they get bigger, they get more efficient, their rhythms change,
Speaker 3: and they have conditions that we would pick up on
Speaker 3: ACGS and echo that would be considered pathological, right, But
Speaker 3: because they're athletes, these are changes that do occur in
Speaker 3: athletes as their hearts remodel, and they're not a sign
Speaker 3: of disease. Right. If if you took someone who wasn't
Speaker 3: highly fit and had so for example, if you screen
Speaker 3: someone's heart and you saw that it was very large
Speaker 3: and they didn't exercise, you might be concerned. But if
Speaker 3: you're you know, an elite cyclist where your heart gets
Speaker 3: very big, it's going to be bigger. And so what
Speaker 3: we have struggled with for a number of years is
Speaker 3: what is normal in the athlete that would be considered
Speaker 3: abnormal in the general population. Italy has a really good
Speaker 3: job on this, so start going back into the nineteen eighties,
Speaker 3: they started to collect data because that's what we need, right,
Speaker 3: we need data from athletes, and they created a huge
Speaker 3: database which actually us in my class now to teach
Speaker 3: and say, you know, if you have an athlete and
Speaker 3: you see these things, these are things we wouldn't be
Speaker 3: concerned about, or here's some markers where we might be concerned,
Speaker 3: and so we have to look further. And then here's
Speaker 3: some things where it doesn't matter whether you're an athlete
Speaker 3: or you know, someone who sits on their couch all day,
Speaker 3: that's a problem. But without that data, we didn't we
Speaker 3: didn't have that ability. And so I think the last
Speaker 3: time is twenty eighteen. The Europeans updated their criteria. Each
Speaker 3: time they update it, you know, we add new things
Speaker 3: or modify things that are in there. So you would
Speaker 3: have had abnormal things. You may have had abnormal things
Speaker 3: on your ACG that the cardiologists would have looked at
Speaker 3: and said, well, according to our athlete standards, that's okay,
Speaker 3: and we're going to ignore it. And we didn't have
Speaker 3: that until relatively recently.
Speaker 1: Okay, yeah, I do remember.
Speaker 2: I think like having a resting heart rate, which we'd
Speaker 2: be considered like pathologically or like dangerously low with the
Speaker 2: thing would get.
Speaker 3: Yeah, braid of cardio, so it's called braid of cardio
Speaker 3: is obviously very common, right, And I give an example
Speaker 3: of my class every year where you know you have
Speaker 3: an athlete, their heart rate can be forty beats for
Speaker 3: a minute. And so I said, you know you would
Speaker 3: ignore that, you know the earl elite cyclists. I get that.
Speaker 3: And then I give an example where it's a woman
Speaker 3: she's sixty three years old or resting, heart rates forty
Speaker 3: two beats a minute, she doesn't do any exercise, and
Speaker 3: the physicians are like, oh, she must be very healthy.
Speaker 3: I'm like, no, that's not normal. And so it turned
Speaker 3: out so the reason they flagged her was because she
Speaker 3: kept passing out because she was braid of kartic, and
Speaker 3: she eventually broke her nose and she was sent to
Speaker 3: the hospital. They did a genetic test and found that
Speaker 3: she had a cardiac arrhythmia. Rights So my what I
Speaker 3: always teach my students is don't just look at the monitor,
Speaker 3: look at your patient. Right, So when your heart rates
Speaker 3: forty beats a minute and they're cycling away and you know,
Speaker 3: he's like, yeah, that person's very fit, and it's like
Speaker 3: when you look and they're eighty years old and they're
Speaker 3: passing out, forty beats of minuted is not normal, right,
Speaker 3: And so we don't need real high standards for some
Speaker 3: of these things. But some of them we did.
Speaker 2: Yeah, and I wonder like people listening will probably be
Speaker 2: sufficiently afraid now, but I'm not, hopefully not too afraid.
Speaker 2: But like lots of people these days are monitoring their
Speaker 2: heart rate all the time, right, They have watches, they
Speaker 2: have wristbands when they're exercising, they have chest bands, so
Speaker 2: you can monitor your heart real kinds of bass these stage.
Speaker 1: You can wear a ring.
Speaker 2: Would any of those devices be useful in predicting or
Speaker 2: seeing families things?
Speaker 3: Not really, only because they're they're very limited. Souse. Great,
Speaker 3: people measure their heart rate because it is a general
Speaker 3: sign of health and so good lowering rest lower resting
Speaker 3: heart rates very good. And when you're exercising, you want
Speaker 3: to bring your heart rate into certain zones uh to
Speaker 3: have effective workers. So that's all great. So I'm not
Speaker 3: trying to discourage people from from doing that. But if
Speaker 3: you want to diagnose long QT syndrome, for example, in somebody,
Speaker 3: that requires calculations, So for sure, you need to measure
Speaker 3: things very accurately. When I'm sure when you had your
Speaker 3: your traits done you would have had multiple electrodes stuck
Speaker 3: on your your body, because yeah, we typically do what's
Speaker 3: called the twelve lead ECG, and so there's there's multiple
Speaker 3: electrodes and they have to be positioned in certain places
Speaker 3: in order to measure how the heart basically the heart's
Speaker 3: electricity is flowing in certain directions because that actually tells
Speaker 3: us something. So when you have I mean, I have
Speaker 3: a device that I use to teach and to illustrate people,
Speaker 3: and it's on the back of my cell phone and
Speaker 3: they could just you know, you put your fingers on
Speaker 3: it and you can you can you can measure things
Speaker 3: and you get an ECG off that. So it looks
Speaker 3: really neat and it's great for teaching, But I'm not
Speaker 3: going to diagnose somebody with regardless syndrome or long QT
Speaker 3: or any of those those things. Those are much more
Speaker 3: in depth. It's required much more in depth equipment to do.
Speaker 2: Something like that, right, Yeah, yeah, definitely. Like sometimes when
Speaker 2: you ride under electricity pilants, you'll see a heart rate
Speaker 2: of two hundred and forty.
Speaker 1: And it will be concerning.
Speaker 2: Okay, didn't work out what was connected to it. So
Speaker 2: if these things are occurring, and obviously they occur, it's
Speaker 2: sort of at a certain percentage of young athletes and
Speaker 2: certain percentage anywhere else? Are there ways that these cerdaen
Speaker 2: kadiak risks we could reduce the number of them that
Speaker 2: result in death?
Speaker 3: Yeah, no, for sure. So CPR. So the people who
Speaker 3: die quite often die because there's there's nobody there to
Speaker 3: administer CPR, and so you lose that very valuable time.
Speaker 3: And so people are concerned about, you know, stepping in
Speaker 3: and doing something and potentially hurting someone. If someone is
Speaker 3: dead like that, you're not going to hurt them, right,
Speaker 3: So you know, please learn CPR. It's not difficult. They
Speaker 3: can certainly do that. You know. In Canada, abouteen years
Speaker 3: ago now, the Heart instruct Foundation of Canada raised a
Speaker 3: tremendous amount of money to put we call automatic extrungt
Speaker 3: defibrillators or AEDs in public places. I think they put
Speaker 3: fifteen thousand of them. Plus companies will buy them for
Speaker 3: their o their workplaces and things like that. And so
Speaker 3: if someone goes down and their heart stops, you take
Speaker 3: these things out. There's some patches. It comes with instructions
Speaker 3: like it will tell you actually what to do, and
Speaker 3: you take it out, you put the patches on the individual,
Speaker 3: you step back because it will deliver a shock and
Speaker 3: it will automatically shock their heart trying to get it
Speaker 3: back into rhythm. So knowing where those are, I'll say,
Speaker 3: knowing how to do them, you don't necessarily need to
Speaker 3: practice because it will walk you through it. But at
Speaker 3: least knowing where they are and not being afraid to
Speaker 3: use them, I think is very important. These quick reactions
Speaker 3: in administering care before the paramedics or someone else gets
Speaker 3: there is super important. If you let someone go five
Speaker 3: ten minutes without any you know, CPR or anything like that,
Speaker 3: there's a tremendous amount of damage that's done and it
Speaker 3: can't be overcome.
Speaker 2: Okay, Yeah, And I think in a lot of places
Speaker 2: in the US, certainly like you can access free CPI
Speaker 2: AED training or your.
Speaker 1: Employee might pay for it.
Speaker 2: And I don't do you know any resources people could
Speaker 2: use to find where they can find that free training.
Speaker 3: So in the States that the American Heart Association would
Speaker 3: be a good place to go, the American Red Crop,
Speaker 3: I'm sure they'll have resources in Canada's Heart and Struck
Speaker 3: Foundation of Canada, Saint John's Ambulance, But like you said,
Speaker 3: a lot of just you know, local community centers will
Speaker 3: put these things on a couple of times a year,
Speaker 3: you know, just so that people are familiar with with
Speaker 3: how to do it. Work places will sometimes do it
Speaker 3: once or twice a year. Have training a lot of
Speaker 3: people to just learn how to how to do it. Yeah,
Speaker 3: I'm not sure where people if you just go on
Speaker 3: the internet and wherever you are and look for first day,
Speaker 3: a lot of times it falls on your first day.
Speaker 3: But if you just google your city and CPR, I'm
Speaker 3: sure something will come up. And I bet there's something
Speaker 3: this month you could go to nice.
Speaker 1: Yeah.
Speaker 2: Yeah, we've spoken before back to stop the league courses
Speaker 2: and have their real set free and easy to exist.
Speaker 2: People could do both of value to be really set
Speaker 2: up to help people. Glynn, is there anything else you
Speaker 2: think people ought to know about these sudden sudden kindia
Speaker 2: arrest there sort of with the conspiracy theories around them,
Speaker 2: or anything else they can do to protect themselves through
Speaker 2: other people.
Speaker 3: Well, I think there's the perception that that by saying
Speaker 3: that there's not an issue, that it means we don't
Speaker 3: we don't care. In fact, we do care about these
Speaker 3: these issues. Like I said, I've taught about this for
Speaker 3: you know, over a decade. I have a background and
Speaker 3: doing some sports medicine work a long time ago. I
Speaker 3: certainly have a strong interest in helping these people. When
Speaker 3: we say the risk is not going up, it doesn't
Speaker 3: mean that we don't care. And so you know when
Speaker 3: a soccer player, a football player, somebody goes down on
Speaker 3: the court, that we just say, well, yeah, it happens.
Speaker 3: It's not what we're saying. We're saying we know these
Speaker 3: things happen, we do care about them. I would actually
Speaker 3: flip this around the other way and say, some of
Speaker 3: these people, the people who I'm talking about, the people
Speaker 3: who are profiting off that's not people who are like,
Speaker 3: I had no idea this was happening. That's okay, you know,
Speaker 3: not everybody can know everything. But the people who are
Speaker 3: saying this is increasing and they're making money off these
Speaker 3: things by selling their movies and whatever. Did you not
Speaker 3: care when someone you know died in twenty fifteen because
Speaker 3: they were in twenty nineteen, they were dying and kids
Speaker 3: were doing it. And if you'd like to come to
Speaker 3: my class I and show you, you know, the pictures
Speaker 3: of these people because you weren't around then. And I'm wondering,
Speaker 3: I'm not really wondering why you're around now? I know
Speaker 3: why they're they're around now. They're profiting off of this,
Speaker 3: And so I would actually flip it the other way
Speaker 3: and say, you know, have them ask them why is
Speaker 3: this new to them when we've when the data show
Speaker 3: this has been happening all.
Speaker 2: Along, right, Yeah, And by encouraging people not to get vaccinated,
Speaker 2: they're encouraging it base themselves at a higher risk for
Speaker 2: cardiac issues, right, for presumably a profit motive in some cases,
Speaker 2: which is very sad. Glenn, where can people you do
Speaker 2: some excellent threads on Twitter so people can learn a
Speaker 2: lot about heart stuff. There is there anywhere else or
Speaker 2: where do you prefer people to find you? I guess online?
Speaker 3: Yeah, No, we do a lot of social media stuff.
Speaker 3: There's a lot of I know, people complain about Twitter.
Speaker 3: I complain about Twitter, but there's a lot of really Twitter,
Speaker 3: a lot of really good people on there who you
Speaker 3: know present their information. You know, you can just want
Speaker 3: to look for those people there. What I would say
Speaker 3: is like, how do you identify who are the good
Speaker 3: people who you can trust? The stuff is the people
Speaker 3: who are able to be transparent with where they get
Speaker 3: their information. Right, So when I say you know, the
Speaker 3: vaccines reduced your risk of these major cardiovascular events. I
Speaker 3: typically provide a study or something like that to show
Speaker 3: where I got that information. The people who are less
Speaker 3: trustworthy will say, you know, either go find it yourself
Speaker 3: because they don't know, or well, I can see it.
Speaker 3: I know what's happening. You know, a lot of these
Speaker 3: things are measurable, so we should be able to find those.
Speaker 3: A lot of us write on things. I've written for
Speaker 3: the Conversation Science two point zero. You know things will
Speaker 3: be there. But social media is a good place to
Speaker 3: go because you can interact with you and you can
Speaker 3: ask those those questions. So yeah, yeah, you can reach
Speaker 3: out to me and see who I follow and who
Speaker 3: I interact with if if, if you're interested in that,
Speaker 3: you could take that as a good or a bad sign.
Speaker 3: However you you want.
Speaker 1: To take it what you handle on Twitter.
Speaker 3: So my handle is Glen g l e n pile
Speaker 3: p y l E. I'm also on the sky I
Speaker 3: just joined that the other day, so nice.
Speaker 1: Congratulations. Yeah, that's great.
Speaker 2: I think the last point you made is one that
Speaker 2: we should maybe pursue another episode on because we the
Speaker 2: difference between anecdote and data and like, so there is
Speaker 2: an increasing number I think of people doing things that
Speaker 2: look a lot like journal articles, are a lot like
Speaker 2: studies that a peer reviewed that are not in trying
Speaker 2: to kind of leverage the credibility of that without actually
Speaker 2: doing peer review science because the stuff they're doing wouldn't
Speaker 2: line up with with peer reviewed science. So it'd be
Speaker 2: interesting to.
Speaker 3: Write there, right, Yes, yes, it was a whole episode too.
Speaker 1: Yeah yeah, next time. Well, thank you so much for
Speaker 1: your time, JN.
Speaker 3: Thanks very much, James, I appreciate it. It could happen
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