Harvard Heart Letter

A no-surgery fix for atrial fibrillation?

Catheter ablation can halt atrial fibrillation, but side effects and durability pose problems.

What's the best way to treat atrial fibrillation, the fast and chaotic beating of the heart's upper chambers? Taking medicine to help the heart maintain a normal, steady beat sounds like a logical strategy. But the drugs for doing this don't always work and sometimes cause side effects as bad as the disease. Another option is taking medicine to make the powerful lower chambers (the ventricles) keep a slow, steady beat no matter what the atria are doing.

A third option is emerging from laboratories and clinics around the world: a procedure to neutralize the errant electrical signals that cause atrial fibrillation. The most mature of these procedures, called pulmonary vein isolation or catheter ablation, has been around since the late 1990s. But it is only now reaching the point where it is becoming an accepted option for treating atrial fibrillation.

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