Atrial Fibrillation: What Causes it and What are the Preventative Measures [transcript][audio]

Guest: Professor Huyen Tran

Presenter: Tabetha Moreto

Guest Bio: Professor Huyen Tran is the is the head of the Haemostasis Thrombosis Unit, The Alfred Hospital Chair, Clinical Trials Group, Thrombosis & Haemostasis Society of Australia and New Zealand or THANZ. He is an experienced Associate Professor with a demonstrated history of working in the higher education industry. Skilled in Clinical Research, Medical Education, Epidemiology, Thrombosis, and Medicine. Strong education professional graduated from Monash University. His focus is on clinical research in haematology with particular interests in thrombotic, bleeding and platelet disorders, and obstetrics haematology.

Segment Overview: In today’s interview, Dr. Huyen Tran discusses about the nature of a condition called Atrial Fibrillation (or Afib) along with its causes and what can be done to prevent it. He also talks about the correlation between Afib and stroke.

Transcript

Tabetha Moreto: Hello everyone, welcome to Health Professional Radio. I’m your host for today Tabetha Moreto. Our guest today is Professor Huyen Tran. He is the Head of Haemostasis Thrombosis Unit at the Alfred Hospital Chair Clinical Trials Group Thrombosis and Haemostasis Society of Australia and New Zealand. Today, we’re going to talk about a condition called ‘Afib’ and how Australians are not connecting the dots between afib and stroke. Without further ado, welcome to the show Professor. I’m so happy you can join us today.

Huyen Tran: Thank you very much for having me. It’s a pleasure.

T: I’m so happy too. Okay. So Professor, can you tell the audience more about yourself and the nature of your work?

H: So I’m a hematologist and my interest is in thrombotic and bleeding disorders and that’s been my passion professionally and atrial fibrillation happens to be one of those conditions that can lead to blood clots and importantly ischemic stroke. This condition is a common one and so if I can lay the background to you, worldwide, at the moment there’s about thirty three and a half million people with this condition atrial fibrillation. And importantly, it contributes to about 15% of the 15 million episodes of stroke that occurs worldwide. So numerically, this equates to about 2.25 million strokes per year. In Australia each year, we’re seeing about 51,000 episodes of stroke and so 15% of that is substantial. The thing with atrial fibrillation is it’s a disorder that becomes more common as we age. And it’s a situation where it’s an arrhythmic problem of the heart and so it leads to a disturb blood flow within the chambers of the heart where you can have slowing of the blood flow and occasionally pooling of the blood flow. So when that occurs, you can have blood clot formation in the chain of the heart. And the danger of this is that it can break off and embolize so it floats off to other organs and most importantly ischemic strokes. And if you have an ischemic stroke, it can be quite devastating in terms of long-term morbidity and mortality. So the intention here is to make people more aware of atrial fibrillation, to seek medical attention and then the very effective therapy which is essentially to thin out your blood to try and prevent people from having ischemic stroke.

T: I see. This sounds like a very dangerous condition and people should be more informed about this. And speaking of this condition, who are the people who are at risk of getting afib?

H: So the at risk, falls firstly on ageing. Sadly, we all get older and this condition becomes more common as we age. In addition, there’s other medical conditions such as high blood pressure or hypertension, diabetes, heart failure, vascular disease, of course people who have had strokes before. Importantly at the general population level, we think alcohol is a potential risk factor as well. But these are the main risk factors that people need to be aware of.

T: Yes, that’s true. And also I want to ask you something about the condition, how can one get tested for afib? What can they do about it? How can a person know they have the condition or let’s say they’re at risk of getting the condition?

H: So firstly, be aware that you could be at risk as we get older. And then be on the lookout of some of the symptoms. And indeed they can be a bit subtle or unusual and simple things like feeling an irregular heartbeat, palpitation, if you feel breathless, if you get chest pain, lightheadedness and you should be proactive about this and go off to your general physician, your family doctor and have it checked out. And they can simply do what we call an ‘Electrocardiogram’ or an ECG and that will really be able to pick up the condition.

T: That’s excellent. I’m glad to hear that. For this particular condition, there’s a way to get tested for it. Now let’s talk about treatments, what are the available treatments for this condition?

H: So the most important treatment in afib to prevent ischemic stroke is anticoagulation or to thin your blood out. So traditionally, we had an oral tablet called ‘Warfarin’ which we had for a long, long time since last century. But more recently in the last decade or so, we’ve got these new, we call them ‘Direct Oral Anticoagulants’ where it’s been very well studied in many clinical trials and it’s been shown that it’s very effective in preventing ischemic strokes in patients with Afib.

T: It’s good to hear that there are available treatments for this. And now, let’s talk about misconceptions. Are there any misconceptions about this condition that drive you crazy and they keep you up at night and you also want to clear up on the show today?

H: Yes. So I think awareness is a really important issue because if we take back what I said early in the show about 51,000 are shown having a stroke per year, 15% of these can be considered atrial fibrillation. One of the societies I work with, the International Society of Thrombosis and Haemostasis did a survey over the last short period of time and the awareness of Afib in Australia in patients or individuals who are 40 or older is only about 50%. That’s a concern because even though these people who are surveyed are aware up to the level 80% that stroke is dangerous, there’s not a good connection on understanding that atrial fibrillation can lead to stroke. So we make people more aware of atrial fibrillation and they get proper treatment. We should be able to reduce the number of strokes that we see each year in the community.

T: Very good. Thank you so much Professor for clearing up these misconceptions and I’m glad that you’re on the show today because this gives both of us the opportunity to share with the audience about this condition and what they can do to prevent it and what they can do if there’s someone listening out there who has this condition, what they can do to maintain their good health.

H: Absolutely. If you’re worried, please go see your family physician firstly.

T: Okay. And now Professor, what is your main takeaway message to all of our listeners out there?

H: Advice? At the age of 40, you get some of symptoms that we discussed about and you have concerns, please go see your family physician to make sure whether or not you do have atrial fibrillation. If you do then we go forward to give you the appropriate treatment to stop you from getting an ischemic stroke.

T: Excellent message Professor. Now for those who are interested about getting tested for Afib or they want to know more about it, how can they get in touch with you?

H: So I work at the Alfred Hospital in Melbourne, Victoria. I’m also with the Monash University, but also I just want to highlight that there’s a number of societies out there including the Stroke Foundation, the Cardiology Society, these are readily available on the internet and they can link and get some more information to satisfy themselves but importantly at the same time, they really should see a doctor who’s have an understanding about this condition to further the treatment.

T: That’s excellent. Thank you so much Professor for coming on the show. I really appreciate it.

H: Pleasure. Thanks for having me.

T: And that was Professor Huyen Tran, the Head of the Haemostasis Thrombosis Unit, The Alfred Hospital Chair, Clinical Trials Group (THANZ). We’ve just been talking about a condition called ‘Afib’. If you liked this interview, transcripts and archives are available at www.hpr.fm. We’re on all social media platforms so don’t forget to follow, like and subscribe. We’re also available for download on SoundCloud and iTunes. I’m Tabetha Moreto and you’re listening to Health Professional Radio.

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