A-Fib/Interventional Cardiology

Dr. Ganiyu Oshodi discusses symptoms of A-fib, how it's dianosed and treatment options available.
A-Fib/Interventional Cardiology
Featured Speaker:
Ganiyu Oshodi, MD
Ganiyu Oshodi, MD, FACC, FHRS, has been practicing medicine for over 25 years and has a reputation for his compassion and dedication to bringing exceptional cardiology, electrophysiology and vascular care to people of the Inland Empire and is On the Medical Staff of Temecula Valley Hospital. 

Learn more about Ganiyu Oshodi, MD
Transcription:

Melanie Cole (Host):  Atrial fibrillation is one of the more common abnormal heart rhythms.  The good news is that there are treatments that are proving to be very effective and can lead to better outcomes for patients with atrial fibrillation.  My guest today is Dr. Ganiyu Oshodi.  He’s an electrophysiologist, an interventional cardiologist, and a member of the medical staff at Temecula Valley Hospital.  Dr. Oshodi, I’m so glad to have you with us today, and as we’re going to talk about a-fib, before we do that, not everybody knows what it is that you do.  Please tell us what’s an interventional cardiologist?

Ganiyu Oshodi, MBChB, FACC, FHRS (Guest): It’s my pleasure to be here today to talk with you about interventional cardiology.  Basically, interventional cardiologists tend to take care of the arteries of the heart because the arteries need to give the heart its own blood supply and its oxygen supply.  Interventional cardiologists can help to open up those arteries if they’re blocked by using stents or balloons.  Also, an interventional cardiologist helps to prevent these sorts of blockages from happening or from progressing.   So, we provide a full spectrum of care to keep the heart arteries open, while we also provide care on the arteries of other part of the body, such as the arteries of the legs and the general full spectrum of cardiac care.
 
Host:  Well, thank you for explaining that.  So, then let’s talk about atrial fibrillation; it’s pretty common.  Tell us what it is, and who is at risk? 

Dr. Oshodi:  Atrial fibrillation is an irregular beating of the heart.  The top chambers of the heart are fibrillating when they start to beat irregularly.  People who are at risk are basically most adults.  It tends to occur as people get older.  So, usually people in their 50’s and 60’s tend to get atrial fibrillation, but it’s very common.  It may occur in up to 25% of people as they get older.  Sometimes younger people get into atrial fibrillation, people in their 30’s or 40’s, but most of the time as people get older, they become at risk for atrial fibrillation.  

Host:  Would we know that we have it since you’ve described who’s at risk, but some people don’t really know that they have it.  Is it found incidentally on an annual wellness exam or would we notice some symptoms?

Dr. Oshodi:  Well, people are different.  Some people have symptoms, and they tend to have symptoms such as irregular beating heart, palpitations, tiredness.  Some people can feel light-headed.  A few people have no idea that they have atrial fibrillation, and it can be discovered incidentally, but the symptoms to watch out for are palpitations, lightheadedness, a lot of fatigue.  That would be how atrial fibrillation tends to present in most people.

Host:  Then how would you diagnose it if somebody comes to you, and they say, I’m noticing a fast heartbeat, or I’m feeling really anxious, or I noticed some palpitations.  What do you do to diagnose it?

Dr. Oshodi:  Well, it’s usually diagnosed by an electrocardiogram, which is an EKG.  That’s usually done in the doctor’s office or in any medical setting, and that gives us an idea of what’s going on with the heart rhythm, and that’s how you diagnose atrial fibrillation.

Host:  So, then, let’s talk about treatments, the first line of defense, if you determine that someone has this, and whether or not they have it all the time or just sometimes. What are the main goals?  Are you trying to stop the symptoms or cure the a-fib?  Do you look to medications or do you look to interventional procedures?  Tell us what you would do first.

Dr. Oshodi:  Well, there are two important things about atrial fibrillation.  The first thing is that in certain people, atrial fibrillation would increase their risk for having a stroke.  So, the first thing we do is try to reduce the risk of having a stroke and that usually involves blood thinners.  Now, this is not for everybody with atrial fibrillation, but a large number of people with atrial fibrillation have additional risk factors for stroke, and that’s what you do to reduce the risk of stroke, which is blood thinners.  The second half of atrial fibrillation is to make people feel better, and that is when we get into how do we treat the actual atrial fibrillation.  Two options for treating atrial fibrillation are medications or procedures.  Now, procedures are more effective than medications, but some people prefer to try medications first because they’re a little apprehensive about procedures.  The procedures that we do for atrial fibrillation usually involve isolating or ablating the pulmonary veins.  These are the veins that go to the left atrium, which is the left side of the heart.  A couple of ways we do this, and one of them involves something called radiofrequency, and the other thing we do is something called freezing, and these tend to stop the veins from transmitting abnormal electricity into the heart—the abnormal electricity that comes from the veins is most often what causes the atrial fibrillation.

Host:  Wow.  That’s so fascinating.  What a great explanation.  So, as we try and picture this and listeners might be doing that as well—try and picture this fast-beating heart, and what you’ve just described with ablating or freezing.  Are these permanent fixes?  Do they sometimes have to be redone, and when would you consider something like a pacemaker?

Dr. Oshodi:  Well, the ablation is very successful, but to be honest, it’s successful in about 60-80% of cases for curing the atrial fibrillation.  Some people have to have more than one ablation, and it may need to be repeated in a couple of months after the first ablation.  So, nobody has been able to achieve 100%, and that’s just not how the treatment works, but for most people, they can get relief from atrial fibrillation with an ablation, knowing that some people will require more than one ablation.  The issue of a pacemaker is more to treat a problem with a slow heart rate, and it’s not often that we tend to do that in atrial fibrillation.  In fact, it’s fairly infrequent.  That is something to do with a slow heart rate, and most people with atrial fibrillation tend to have fast heart rates.

Host:  Well, thank you for clearing that up.  So, now, you know, you’ve done your ablation, and hopefully it doesn’t have to be redone.  What is next for the patient?  Would they still have to be on that stroke prevention blood thinners if you do an ablation?  Is there, you know—what is their life like afterward, and are there any lifestyle things that they can do to help control their symptoms?

Dr. Oshodi:  Yeah, one of the most important things to note is that the ablation itself, while it may help with the symptoms and may help to cure the atrial fibrillation or may help to reduce atrial fibrillation, it does not make it such that the person does not need to be on stroke prevention.  Stroke prevention is something that continues whether or not you have an ablation.  So, if people are on blood thinners for the prevention of stroke, even after an ablation, if they’re feeling better, it is recommended that they continue to be on the blood thinners or whatever treatment it is they’re on to reduce the risk of stroke.

Host:  So, give us your best advice as we wrap up this fascinating segment about atrial fibrillation and what you would like listeners to take away from this.  If there’s somebody who is worried about this, if they have been told that they do have a-fib and hope for the treatments that are out there.

Dr. Oshodi:  Well, one of the most important things to keep in mind is that atrial fibrillation is treatable.  There are lots of treatments available to make people feel better.  It would very good to contact or connect with an electrophysiologist who can help you manage the atrial fibrillation.  The ablation treatments that we have now have been just improving every week, every month, where the technology keeps getting better, and we’re getting better and better results with ablation.  So, people don’t have to continue to suffer with the symptoms or to feel bad.  The treatment is available.  Now, it’s also important that when you see your electrophysiologist, you get evaluated to see if you have an increased risk of stroke, and if that happens, then you will need to be on treatment to reduce your risk of stroke because that is one of the most important things about treating atrial fibrillation, but we do have treatment for atrial fibrillation, and in most people, we can get very good results.

Host:  Thank you so much, Dr. Oshodi, for joining us today and sharing your incredible expertise.  Thank you for letting us know what treatment options are out there for atrial fibrillation, and that wraps up this episode of TVH Health Chat with Temecula Valley Hospital.  Head on over to our website at temeculavalleyhospital.com for more information and to get connected with one of our providers.  If you found this podcast as interesting and informative as I did, please share with your friends and family.  Share on your social media.  Odds are you know someone with a-fib, and they would like to hear this great information, and don’t miss all the other interesting podcasts in our library.  Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital.  The hospital shall not be liable for actions or treatments provided by physicians.  Until next time, this is Melanie Cole.