Cardiac Electrophysiologist

Dr. Ashwani Bedi on Heart Health for Life and the Results of Decades of Research

Northern California Medical Associates (NCMA) Dr. Ashwani Bedi discusses the results of this month’s study on heart disease.

Earlier this month researchers from the Chicago Heart Association Detection Project released results of a study focused on 25,800 people who had turned 65 by 2010. Pulling data from the same participants who also made up a study from 1967 to 1973, researchers looked at heart health during younger years and how that played out over time.

They found that people with favorable heart health at younger ages lived about four years longer altogether, survived about five years longer before developing a chronic illness such as cancer or heart failure and spent 22 percent less of their senior years with a chronic disease compared to people with two or more heart risk factors earlier in life. This group also saved almost $18,000 in Medicare costs.

“Cardiovascular health is a lifetime concern,” says Dr. Ashwani Bedi, NCMA Cardiologist. “The American Heart Association says that about 41 percent of the U.S. population will have cardiovascular disease by 2030. That is a shocking statistic. This study clearly demonstrates that life-long heart health can be achieved, if patients make it a priority early in life. It’s hard to imagine a simpler solution than that.”

Cardiovascular disease includes conditions that affect the structures or function of the heart. It is the leading cause of death in the U.S. causing more than 800,000 deaths per year and $300 billion in direct medical expenditures. “The best way to prevent cardiovascular disease is to learn about it early and to take steps to prevent it from occurring,” says Dr. Bedi.

As a practicing Cardiac Electrophysiologist who specializes in the diagnosis and treatment of abnormal heart rhythms, Dr. Bedi understands the importance of prevention and the need to make lifestyle changes early in life to help ensure a healthy heart for life. “It’s human nature to not focus on our cardiovascular health until later in life when it becomes a problem. This study shows the importance of making lifestyle changes to support heart health earlier in life.”

How to prevent heart disease

Heart failure is a major health problem for both men and women in the U.S., affecting nearly 5 million Americans. About 550,000 people are diagnosed with it each year. It is the leading cause of hospitalization in people older than 65. The hallmarks of prevention for heart disease include:

  • Eating healthy
  • Getting active
  • Maintain a healthy weight
  • Quit smoking and avoid secondhand smoke
  • Manage cholesterol and blood pressure
  • Drink alcohol in moderation
  • Take steps to manage stress

“Ultimately, it’s never too early or too late to learn about heart disease. The earlier in life a person can take steps to prevent cardiovascular disease, the better the chances that person has for staying healthy for life,” Dr. Bedi said.

About Dr. Bedi

Dr. Bedi is board certified in cardiac electrophysiology, cardiovascular disease and internal medicine. He brings specialty expertise in all aspects of cardiac electrophysiology including SVT and VT ablations, atrial fibrillation ablations, pacing (including BiV pacing) and defibrillation as well as intracardiac echocardiography. Dr. Bedi was the recipient of the Health Care Hero Award and received multiple WOW designations at Deaconess Hospital in Evansville, Indiana. He has a professional interest in cardiac ablations, prevention and awareness of sudden cardiac death in communities and has been actively involved in cardiac screening for college athletes.

For more information about the full range of services offered by Northern California Medical Associates, visit the NCMA Health website. To make an appointment with Dr. Bedi, call (707) 573-6199

NCMA Cardiologist Jaime Molden Explains Latest in Catheter Ablation Treatment for Atrial Fibrillation

 Jaime Molden, MD, FACC, FHRS Electrophysiologist

Jaime Molden, MD, FACC, FHRS

Northern California Medical Associates (NCMA) Cardiology offers expert atrial fibrillation care from leading specialists in the North Bay region. Cardiac Electrophysiologist Jaime Molden explains the current guidelines for treating atrial fibrillation with catheter ablation—an invasive, nonsurgical procedure that may reduce patient reliance on toxic medications.

Atrial fibrillation (Afib) is a common, potentially life-threatening heart condition in which the upper heart chambers beat out of sync with the lower chambers, causing an irregular heartbeat. Although the arrhythmia causes only a small increase to one’s risk of early death, the condition can evolve when left untreated over time and become very serious. In addition to life-changing symptoms of fatigue, palpitations, shortness of breath, inability to exercise, chest pain, and syncope, patients with Afib live with increased risk for an array of serious life-threatening health problems including stroke, cardiomyopathy, and heart failure.

Cardiologists have been helping patients manage their Afib for decades primarily with anti-arrhythmic drugs (also known as AADs or “rhythm drugs”). While these drugs are proven effective, the degree of efficacy varies from patient to patient, and side effects from taking these medications over extended periods of time can cause serious complications. Catheter ablation for Afib first became a viable treatment option in the early 1990s, and researchers and cardiologists have studied its efficacy ever since, fine-tuning the procedure throughout the process. Today, catheter ablation is gaining traction in the treatment of Afib as it has shown to help certain patient groups return to healthy heart rhythms while reducing their reliance on medications, which can have significant side effects.

NCMA Cardiologist Jaime Molden, MD, studied cardiac electrophysiology during his fellowship at Cedars Sinai Medical Center in Los Angeles. Dr. Molden regularly treats patients with Afib and he is a leading specialist in the area of catheter ablation techniques.

Dr. Molden explains, “Treating Afib remains a challenge to cardiologists today. There are three types—paroxysmal, persistent, and permanent—and treatment varies depending on which type the patient has. Paroxysmal is generally described as lasting less than 48 hours at a time. Persistent Afib lasts more than a week or requires an intervention to terminate it. Permanent Afib lasts longer than a year. Paroxysmal Afib patients have better treatment prognoses than persistent and permanent patients, but both paroxysmal and persistent Afib can become more frequent over time if untreated or treated ineffectively. Since many treatments are available but none that will work the same for every patient, treating Afib demands cardiologists’ full attention to detail in each individual case.

Treatment of Afib is always individualized to the patient. Many patients want to get off of their anti-arrhythmic medications altogether, and others want to simply minimize symptoms. When symptoms persist, more catheter ablation procedures can often get patients to where they want to be, with the type of Afib playing a significant role in the efficacy of the treatment. Patients with paroxysmal Afib can achieve excellent results with a single ablation procedure.

In the procedure, we use several different diagnostic catheters and an ablation catheter to map out and treat the areas of the heart that are causing the abnormal rhythm. In the vast majority of patients, arrhythmia is triggered by pulmonary veins firing electrical signals in an irregular, chaotic pattern. With catheter ablation, lesions (‘burns’) are made around the opening of each pulmonary vein until there is no electrical conduction into the vein. What we are essentially doing is cutting off ‘communication’ between the misfiring vein (or veins) and the heart by modifying the tissue in a precise area. We can then test the results to ensure that there is no conduction between the heart and the misfiring vein. After catheter ablation, a patient’s pulmonary veins will still fire an electric signal that would normally cause arrhythmia, but the signal cannot pass through the ablated tissue, and sinus rhythm (normal rhythm) is maintained.

Catheter ablation for atrial fibrillation is becoming more widely used within the medical community for several reasons. It likely has a more favorable success rate than anti-arrhythmic drugs. Analysis of landmark Afib trials like AFFIRM, RACE and RACE II suggests that rhythm control with drugs and cardioversion benefit the patient by maintaining sinus rhythm, but the toxicities and adverse effects associated with AADs negate the positive effects. The subset of patients who responded well to the treatment, meaning that their normal rhythm was maintained with little adverse reactions to the drugs, had lower morbidity rates than the overall population of patients in the study. This suggested that non-pharmacologic therapies might allow us to achieve the larger benefits of maintaining sinus rhythm.

While studies into the efficacy of catheter ablation are ongoing, results from recent research demonstrate that approximately 60-70% of patients with paroxysmal Afib can enjoy freedom from arrhythmia after a single procedure. With two or more procedures, the efficacy increases further. The research also indicates a higher success rate for paroxysmal patients when compared to rates for persistent or permanent Afib patients. Patients with paroxysmal Afib, accordingly, are better candidates for the procedure than those living with the persistent types.

The risks associated with catheter ablation are serious, but the propensity for major complication is approximately 2% with the overall complication rate in the range of 5%. Compare that number with the propensity for complications associated with anti-arrhythmic drug treatment, and the risks of catheter ablation look even better. While rhythm drug treatment has a lower rate of life threatening side effects than ablation, almost a third of patients on these medications eventually experience an adverse event caused by their treatment, like severe heart rate slowing or the precipitation of other abnormal heart rhythms. Over 10% of patients either find the treatment too intolerable to continue or altogether ineffective.

This leads to the important question—‘When is the use of rhythm drugs warranted?’ New official Afib treatment guidelines in the US now include a treatment route for Afib that removes AADs from the process altogether, allowing patients to opt for ablation before they’ve tried AAD therapy. This is exciting progress, as the new guidelines demonstrate a trend towards replacing a standard treatment with a potentially better one. With that said, we do not have a curative treatment for Afib in 2014. The treatment for this disease will continue to be a combined approach utilizing the existing medicines in as safe a way as possible while applying catheter ablation techniques to the patients who prove to be good candidates.

A trial run with medications is still generally seen as the first option for Afib patients. Also, patients with persistent or permanent Afib may not be eligible for the ablation procedure depending on various cardiac and overall health factors. Catheter ablation for treating Afib has settled in as a viable treatment for patients that meet the right criteria, both without and in conjunction with medications. For some patients, catheter ablation may offer the best outcomes.”

Click here to view Dr. Molden’s complete presentation on Afib catheter ablation from NCMA’s annual symposium.

NCMA offers patients excellent quality and convenience in its comprehensive cardiac and vascular testing services. All procedures are performed by highly skilled and trained registered sonographers, registered nuclear technologists, and/or registered nurses and medical assistants, under the support of our physicians. NCMA’s nuclear and echocardiology laboratories are accredited by the Intersocietal Accreditation Commission. To learn more about NCMA Cardiology or Dr. Molden, please visit, or call (707) 573-6166 to schedule an appointment.


Northern California Medical Associates (NCMA) Welcomes Jaime Molden, M.D. Cardiac Electrophysiologist to the NCMA Cardiovascular Services Team

Northern California Medical Associates’ (NCMA) Cardiovascular Services is delighted to welcome Dr. Jaime Molden to the elite Fountaingrove Cardiology team. Dr. Molden previously served as Medical Director of Electrophysiology at Dixie Regional Medical Center in St. George.


Jaime Molden, M.D. Dr. Molden earned his medical degree from the University of Chicago’s Pritzker School of Medicine, where he was recognized with the Dylan Award in Medical Ethics. Returning to California, and following internship and residency in internal medicine at Harbor-UCLA Medical Center in Torrance, Dr. Molden joined Kaiser Permanente Southern California in Los Angeles as an internist. In 2009 he completed a fellowship in cardiovascular disease at Harbor-UCLA Medical Center during which time he also served as a clinical instructor. Dr. Molden went on to complete the Clinical Cardiac Electrophysiology Program at Los Angeles’s Cedars-Sinai Medical Center in 2010.

Dr. Molden currently holds board certifications in clinical cardiac electrophysiology, cardiovascular disease, nuclear cardiology and internal medicine, as well as, advanced cardiac life support and has authored numerous clinical publications.

Cardiology and More

Dr. Molden is trained to diagnose and treat a variety of heart and cardiovascular conditions including congenital heart defects, congestive heart failure, heart disease, coronary artery disease, heart attacks, arrhythmias, high cholesterol, high blood pressure and many other heart-related conditions. As an electrophysiologist, Dr. Molden is able to also provide advanced diagnosis, treatment and management of electrical- based diseases and disorders of the heart. His education and experience in electrophysiology allows him to perform specialized surgical procedures such as ablation and drug therapy to manage complex arrhythmias.

By joining Northern California Medical Associates’ (NCMA) Cardiovascular Services team Dr. Molden becomes an important part of a highly recognized team of dedicated professionals, all working together to deliver the highest quality care with the best patient results.  Providing treatment and services for everything from cardiac catheterization to open-heart surgery, from electrophysiology to rehabilitation and prevention, this highly  qualified staff not only maintains its commitment to patient health and well-being, they also follow a tradition of excellence and expertise to deliver the most current, innovative treatment in cardiovascular medicine.

Making an appointment

Dr. Molden is pleased to be accepting new patients at NCMA’s Fountaingrove Cardiology office in Santa Rosa. For more information about NCMA visit our site at, and to arrange for an appointment call (707) 573-6199.


Northern California Medical Associates is Northern California’s premier provider of medical and surgical care north of the Golden Gate and has been serving individuals and families since 1975. Every highly skilled professional comprising the NCMA team shares a strong commitment to preventive programs and health screening designed to promote and maintain everyday health. NCMA has successfully built a legacy of excellence that is recognized nationwide.