High-frequency energy waves may substitute for medication

The question: The heart’s electrical system normally maintains a steady beat, but if the impulses are blocked, an abnormal rhythm – atrial fibrillation – can result. Medication often is used to correct this, but some people experience serious side effects from the drugs, and they do not always work. Might a procedure that uses high-frequency waves to destroy the tissue causing the short circuit be a viable alternative?

This study randomly assigned 70 adults with atrial fibrillation to take anti-arrhythmic drugs and an anti-clotting drug or to undergo radiofrequency ablation, administered through a catheter. A year later, 13 percent of those in the ablation group had had one AF episode or more, compared with 63 percent of the people who took medication. People who had had ablation described their quality of life as better than those who had taken the medication.

Who may be affected by these findings? People with AF, which becomes more common with age. More than 2 million Americans have this disorder.

Caveats: Risks associated with ablation include constriction of the pulmonary vein and stroke; complications occur in about 6 percent of the procedures. Different specialists using different ablation techniques may not produce the same results. The long-term cure rate remains unknown. Quality-of-life findings were based on self-reports.

Find this study: June 1 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

Learn more about atrial fibrillation at http://patients.uptodate.com; learn about cardiac ablation at www.fda.gov/hearthealth/ (click “Treatments,” then “Medical Devices”).

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment’s effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.