Harvard Heart Letter

Follow-up: Procedures for atrial fibrillation

Follow-up

Procedures for atrial fibrillation

The March issue of the Heart Letter looked at treatments aimed at curing — not merely managing — the erratic heart rhythm known as atrial fibrillation. A nonsurgical treatment called pulmonary vein ablation is the most advanced. It involves inserting a thin, flexible tube (catheter) into the femoral vein in the groin and gently maneuvering it into the heart. Once in place, radio waves from the tip of the catheter create circles of scar tissue on the inner wall of the left atrium around the openings to the pulmonary veins. This halts electrical activity coming from the pulmonary veins, which is a common trigger of intermittent (paroxysmal) atrial fibrillation.

A report in the March 2, 2006, New England Journal of Medicine raises the possibility that catheter ablation may also work against harder-to-treat persistent (chronic) atrial fibrillation. In a study of 146 men and women whose atrial fibrillation had lasted for six months or longer, 74% of those who underwent catheter ablation were free of atrial fibrillation one year later. Of those who received only drug therapy, 58% had normal heart rhythms.

These results, though impressive, have a lot to do with where the study was done (two centers that specialize in catheter ablation) and in whom (younger people without structural heart problems). If you and your doctor think that catheter ablation might be right for you, seek out a doctor who has a lot of experience performing it.

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