Roderick Tung, MD: Undaunted by the challenges of arrhythmias
September 25, 2020
Many doctors can pinpoint key experiences in their lives that drove them toward the calling to heal.
For cardiologist Roderick Tung, MD, watching doctors save his father’s life and undergoing his own cardiac procedure sparked his passion for medicine and his keen interest in the heart and its electrical impulses.
It was 1994, his freshman year in college, when Tung felt something odd while hanging out with friends in his dorm. He’d been laughing at a joke when his heart started to beat extremely fast, as if it were trying to jump out of his chest.
He checked his pulse: It was racing at 230 beats per minute — two to three times faster than a normal heart rate.
In the emergency room, doctors found Tung’s blood pressure to be abnormally low, and he felt lightheaded. But as doctors tried to start an IV, Tung’s arrhythmia abruptly stopped. He was admitted for observation.
It wasn’t his first experience with hospitals, even at that age. When Tung was 13, his father was diagnosed with colorectal cancer. “I still remember having that feeling of ‘Oh no, I’m going to lose my dad,'” Tung said.
He also remembered how the physicians helped his father through a health crisis and admired their command of knowledge about the human body and how to heal it when things went wrong.
“I watched the doctors come down the hallway with their big white coats and thought, wow, they’re almost like superheroes,” Tung said.
Now, as a patient in the hospital, he was awaiting answers about his own health.
A cardiologist specializing in electrophysiology came to his room the next day, sat on his bed and drew a picture of a heart and its electrical system. He explained that Tung likely had paroxysmal supraventricular tachycardia (PSVT), a condition in which the heart suddenly gets thrown into a short circuit.
In his final year of medical school, Tung underwent a catheter ablation to stop the PSVT from recurring. It’s a minimally invasive procedure that involves threading a catheter into the heart to apply heat that destroys the tissue causing the irregular activity.
Today, Tung is an internationally respected cardiac electrophysiologist and medical director of the Center for Arrhythmia Care at the University of Chicago Medicine’s Heart and Vascular Center. He leads a team of specialists in caring for people from across the country who need treatment for an arrhythmia — when their heart beats too quickly, too slowly, or erratically.
The study of cardiac electrophysiology is still young, and arrhythmias are a complex phenomenon. Irregular heartbeats can be caused by myriad internal and external factors, from obesity, stress and alcohol to genetic conditions passed on from parent to child.
“They’re triggered by so many different things that you really need to holistically know your patient and understand their lifestyle and other health conditions in order to get to the bottom of what's triggering the arrhythmic events,” said Kay Rogien, BSN, MSN, one of the center’s advanced practice nurses.
Cardiologists treat arrhythmias with medications, pacemakers and defibrillators. When these interventions are not enough, catheter ablation is often the next step. Tung is one of only a handful of electrophysiologists in the world who routinely uses epicardial mapping — a procedure that allows him to reach the heart’s outer surface through a small needle-assisted puncture of the heart sac — to conduct ablation procedures for ventricular tachycardia, a dangerous arrhythmia that can lead to sudden death.
A First in Cardiac Ablation
It’s the sort of detail-oriented precision he’s been drawn to since he was young. When he was growing up, his mother, a self-made businesswoman and entrepreneur who co-owned an upscale Chinese restaurant in New York City, often remarked on the little things easily overlooked by others.
“She was always pointing things out in life, whether it was details in a picture, certain colors, gardening or interior design aspects,” recalled Tung. “She taught me to be very attuned to details because she has a very keen eye.”
“We come to work not only to practice medicine, but to change the practice of medicine.”
Attention to detail was critical when Tung and his team performed the first ablation in the country for a woman experiencing recurrent fainting episodes. Called vasovagal syncope, the incidents may occur when a person’s heart suddenly slows or their blood pressure drops. Some common triggers for vasovagal attacks include stress, pain, standing for long periods of time or the sight of blood.
Tung’s patient had experienced fainting most of her life, and a pacemaker to keep her heart beating wasn’t preventing more episodes: Hers was a type of vasovagal syncope in which blood pressure played as strong a role as heart rate. So, she sought out Tung and his team to ablate the problematic nerves that were slowing down her heart — a procedure that had not yet been performed in the United States.
“We try to understand the mechanism, the why of something happening, and then use technology to treat it in new ways,” said cardiac electrophysiologist Gaurav Upadhyay, MD, who performed the ablation with Tung. “As technology improves, we’re excited to use new techniques and a deeper understanding to tackle disease states that were previously considered untreatable by electrophysiologists.”
The woman has been symptom-free for more than a year, and the team plans to further study the effectiveness of ablation on patients with vasovagal syncope who do not respond to other treatments.
Use of 'His Bundle'
Under Tung’s leadership, the Center for Arrhythmia Care continues to break ground on understanding and treating arrhythmia. Last year, it drew attention for research that probed the effectiveness of His bundle pacing (HBP), which involves implanting a pacemaker’s lead in an area of the heart that naturally taps into the muscle’s electrical wiring. (The His bundle is a bunch of specialized heart cells for electrical conduction that were discovered by a Swiss scientist named Wilhelm His Jr.)
Pacemakers have been used for decades to treat patients with abnormal heart rhythms. Usually, doctors implant the leads in the top and bottom chambers of the heart, where they are easy to access.
“The disadvantage with the standard approach is that pacing from the heart muscle ignores and bypasses the heart’s own natural wiring system,” Tung said.
HBP holds promise because the pacemaker lead is placed at the beginning of the heart’s wiring system. The pacemaker’s pulse is then able to physiologically stimulate both of the heart’s lower chambers, the way nature intended, for a more natural, synchronized heartbeat.
The center’s study found that for many patients with heart failure and abnormal heartbeats, HBP may be equally or more effective than traditional biventricular pacemaker, but the pilot study lacked the power to detect smaller differences due to its limited size.
Tung said the data support the need for more studies in the field to gain a better, fundamental comprehension of the mechanisms at play.
Hemal Nayak, MD, Associate Director of the Center for Arrhythmia Care and an expert on lead and device management who worked on the study, said the team is planning additional research to better understand who may benefit from the strategy.
“I would put University of Chicago Medicine as one of the leading sites globally for championing new approaches that try to pace the heart’s conduction system and catheter ablation of complex arrhythmias,” Nayak said.
Tung added that these new tactics are driven by the institution’s history of groundbreaking research and his team’s commitment to innovative, empathic care.
“We come to work not only to practice medicine, but to change the practice of medicine,” he said. “We push for that every day.”
Roderick Tung, MD
Roderick Tung, MD, is an internationally renowned cardiologist and specialist in cardiac electrophysiology. Dr. Tung is an expert in the management of heart rhythm disorders (arrhythmias), with a particular focus on advanced therapies for atrial fibrillation and ventricular arrhythmias.Read more about Dr. Tung
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