Transcription:

Melanie Cole (Host):  Welcome to TVH Health Chat with Temecula Valley Hospital. I’m Melanie Cole and today we’re discussing cardiovascular wellness and heart rhythm disorders. Joining me is Dr. Ganiyu Oshodi. He’s Board-Certified Cardiac Electrophysiologist and a member of the medical staff at Temecula Valley Hospital. Dr. Oshodi, it’s a pleasure to have you join us today. I’d like you to give the listeners a little bit of a physiology lesson today. What’s considered normal heart rhythm and what’s considered abnormal heart rhythm?

Ganiyu Oshodi, MD (Guest):  Hi Melanie. Thank you for having me today. and we are just going to talk about the normal heart rhythm to start with. That’s the heart rhythm that comes from the normal pacemaker system of the heart. It is slow when you are resting and goes up when you are active. It’s called normal sinus rhythm. And in most people, the heartrate is somewhere between 50 and 100. When you’re sleeping it can even be lower like in the 40s. But when you’re active and running around, it can be higher like in – it might be 120, 130 if you’re running or very active. In some people it can go up to 150 if they are very, very active.

The maximum heartrate you would expect would be related to your age and your activity. And then, the abnormal heart rhythm is anything that is not coming from that system which is an unusually slow heartrate such as less than 40 or when you’re trying to be active or trying to walk around and your heartrate does not rise like it should. And it could also be too fast like when you’re resting and doing nothing and all of the sudden you find your heartrate is 140, 150. Those could be abnormal heart rhythms.

Host:  One of the things I find most interesting Dr. Oshodi, as an exercise physiologist, about the heart itself, is that there are different types of disorders. There’s electrical, circulatory, structural. I mean it’s such an amazing organ. Speak about these types that you see most often and really if there are any symptoms that we would feel. Some we do, some we might not. Speak about the different types of disorders that you see every day.

Dr. Oshodi:  Yes, the heart is the center of the circulatory system and thus it helps the body with all the activities that the body does. So, the symptoms that one feels when you have heart problems have a lot to do with your energy, your breathing, a lot of people have fatigue. But when we cone down on heart rhythm disorders, because some of the heart rhythm disorders are manifested by very fast heart rhythms. Those could present with symptoms such as palpitations or feeling like your heart is skipping. They could make you feel out of breath and sometimes you might even feel chest pressure. When the heart goes too slow, then those could cause symptoms like dizziness, some people may faint, and some people may just have fatigue or tiredness. So, those are some of the range of symptoms you could have with the different kinds of heart rhythm disorders.

Host:  So, can they be life threatening?

Dr. Oshodi:  Yes. They could be. And it would really depend on what sort of heart rhythm problem is happening. Some heart rhythms are not life threatening. And some are. Usually, the life threatening ones are related to the actual structure of the heart. People who have weak hearts are more likely to have life threatening rhythms. People who have strong hearts are less likely to have life threatening rhythms. But those are a generalization. For the most part, most of the rhythm problems are not life threatening but there are some rhythm problems that are life threatening.

Host:  Well then tell us a little bit about treatment options Dr. Oshodi. What are the main goals? Are you working on these rhythm disorders themselves or the symptoms or the possible risks, complications, things that they can cause and speak to that a little bit. If they are left untreated, risk of stroke. What are some of the risks of things that can happen?

Dr. Oshodi:  That’s an excellent question Melanie. It really depends on what the rhythm is. Some rhythms have a risk of causing or increasing the risk of stroke and in those situations, our treatments would be to mitigate or to reduce the risk of stroke. Some rhythms, their main problem is the symptoms. Some can make people tired; some can make you have palpitations, and in those rhythms, or those specific conditions, our main focus would be to deal with the symptoms. Well some rhythms are life threatening and, in those conditions, our main goal is to preserve life, to get rid of the abnormal rhythm or to provide treatments that would reduce the chance of the rhythm causing any serious problems.

So, we have a whole range of different objectives when we start to treat people for heart rhythm problems.

Host:  Well then speak about your first line of defense and I know we’re talking about a whole group of disorders here. So, we’re not specifically talking about AFib or something along those lines. We’re talking about various ones. So, when you first look at intervention, is that medicational in nature? Do you look at medications first say to decrease the stroke risk? What are you doing first and then lead us into when an interventional procedure might be required.

Dr. Oshodi:  Excellent. So, we start by trying to identify the rhythm and trying to quantifying the risk for adverse events. Then for instance, a rhythm that has significant life threatening components our main deal, our main plan would be to preserve life. As such, that in people who have problems with ventricular fibrillation, an abnormal rhythm from the bottom of the heart, that is life threatening, we proceed with implanting a defibrillator for such people. In persons who have things like atrial fibrillation, where the risk is a risk of stroke, depending on what other risk factors are happening, we give medications to reduce the risk of stroke and when the main problem is symptoms, we can do procedures or medications to suppress the rhythm or cure the rhythm. Some abnormal heart rhythms can be cured with a procedure and oftentimes, this procedure is called an ablation. For example, with rhythms like atrial fibrillation or supraventricular tachycardia, otherwise known as SVT, those can be amenable to cure, particularly supraventricular tachycardia. Sometimes with one procedure, that rhythm can be cured once and for all. And in those cases, we try to make the procedure available so that we can actually go for a cure for the rhythm. Whereas some rhythms are best treated with management and some people have those sorts of rhythms where we put them on a medication to manage the rhythm.

So, the first thing is always to determine what is the risk from this particular rhythm. Is it a risk of a life threatening rhythm or is the risk a risk of a stroke or is the rhythm mainly something to do with symptoms and quality of life?

Host:  Wow. That was an excellent explanation. Dr. Oshodi, if they have one of these procedures and whether it’s curative or for symptoms, do they still need to take medications such as blood thinners, those sorts of things even if they have one of these procedures?

Dr. Oshodi:  Again, it would depend on the procedure. But that’s an excellent question. It would depend on the condition and the procedure. For the most part, when you have a very curable rhythm such as atrial flutter, once you have the procedure that has more than a 95% cure, you can for the most part, stop the blood thinners after some time and after discussion with your physician. For other rhythms such as atrial fibrillation, you may have to continue the blood thinners for a while, and this may be quite a long while to determine if you’re still have the atrial fibrillation or not. And sometimes when you do a procedure to cure a rhythm, patients may have to actually continue whatever medications they were taking such as the blood thinners even after the procedure.

Host:  So, now I think one of the most important questions as we get ready to wrap up here is is there any way to prevent heart rhythm disorders? I’d like you to speak Dr. Oshodi about cardiovascular wellness and lifestyle changes, behaviors, things that we can do to keep our heart strong and whether some of these disorders are just something that happens or whether we have an option to prevent them.

Dr. Oshodi:  Yes. That’s another excellent question. Some of these disorders are just things that happen. But some of these disorders can be delayed or avoided by following the standard and usual cardiovascular wellness principles which involve anything to help prevent the onset or delay the onset of heart disease. And these principles involve following a very healthy diet, trying to maintain good activity including exercise. It’s recommended that 20 minutes of exercise a day or 150 minutes of exercise a week can be very helpful in maintaining the right health state to reduce or delay the onset of heart disease. So, we’ve discussed diet, we’ve discussed exercise. Maintaining a good blood sugar so that would involve being checked to make sure that one doesn’t have diabetes and if one does have diabetes, getting the right treatment to maintain the blood sugar at a right level. The other things would be avoidance of smoking and this is very important, because smoking makes all forms of heart disease worse and not necessarily just heart disease, other diseases that affect the human system and the other thing would be maintaining a good body weight. So, the standard principles of maintaining good health also apply to heart rhythm.

Now we have talked about maintaining a good body weight, maintaining good blood sugars, maintaining good blood pressure. If someone has hypertension, it should be treated. If someone does not have hypertension, then it should be prevented by making sure you don’t eat too much salt and also maintaining good exercise habits and maintaining the right diet with excellent amount of vegetables and nuts and avoiding very high cholesterol meats.

Host:  Do you have any final thoughts? What an informative episode Dr. Oshodi. What a great guest you are. Can you please just wrap it up with your really best advice, your final thoughts about heart rhythm disorders, cardiovascular wellness and your multidisciplinary approach to cardiovascular wellness?

Dr. Oshodi:  Yes, I think people would benefit from listening to their bodies. If you are having an unusual feeling such as you are feeling lightheaded or you’re feeling palpitations; it’s time to talk to your doctor. Those are signs and possible symptoms of having a possible heart rhythm problem. You should maintain and try to maintain as much as possible good healthy lifestyle to reduce or delay the onset of any possible heart problems and this involves standard things that we usually talk about such as maintaining good health, maintaining good exercise, maintaining good diet. And if you do have symptoms, or if you do have any heart rhythm problems; we have therapies that can either cure the disease once and for all or can reduce the symptoms or manage the symptoms. So it isn’t thing that people shouldn’t feel down about. We do have therapies and we can provide help.

Host:  Great. Thank you so much Dr. Oshodi for coming on and sharing your incredible expertise with us today. That concludes this episode of TVH Health Chat with Temecula Valley Hospital. Please visit our website at www.temeculavalleyhospital.com for more information like this and to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other Temecula Valley Hospital podcasts. 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. This is Melanie Cole. Thanks for listening.