Dear Dr. Roach: In your February column on atrial fibrillation, you did not address a procedure that can be done to cure the condition rather than taking medication. Could you discuss this, and whether medication would be necessary afterward?
C.G.
Atrial fibrillation is a chaotic lack of rhythm in the heart muscle, caused by abnormal electrical impulses. The goal when treating atrial fibrillation is to reduce the risk of stroke and minimize symptoms.
One new approach to treatment is radiofrequency ablation 鈥� that is, using radio waves sent through a small tube placed directly into the heart through a leg or arm vein. The high-powered radio waves can destroy the cells causing the atrial fibrillation, or can isolate those areas from the rest of the heart. A surgeon can do a 鈥渕aze鈥� procedure to prevent the abnormal impulses from affecting the entire heart.
It isn鈥檛 clear yet who benefits most from these kinds of procedures, but early studies have suggested better outcomes and a听good chance for a cure, although sometimes it takes several procedures. There are potentially serious complications, so it should only be done only in centres with extensive experience. It is a good choice for people who experience symptoms and can鈥檛 take medications or for whom medicines failed.
听
Dear Dr. Roach: I have a question about hydrogenated and partially hydrogenated fats. What is the difference? Nutritionists tell us to look out for partially hydrogenated, but never mention the other one. Seems to me both would be bad for you.
D.D.F.
You are quite right. There are four kinds of fat. Two are healthier 鈥� monounsaturated and polyunsaturated, and these are found in healthy oils, such as olive oil and canola oil. Two fats are unhealthy 鈥� trans-saturated, also called partially hydrogenated, and saturated, which is fully hydrogenated but isn鈥檛 ever really called that.
Trans-saturated fat is not healthy. Food companies make it by adding hydrogen to vegetable oil at high temperature. The chemical bonds are 鈥渢rans,鈥� which are not normally found in nature. The process makes the fat more solid at room temperature. It isn鈥檛 much of an exaggeration to call trans fat toxic, since even modest amounts increase risk for heart disease from blockage of the arteries. I recommend as little trans fat in the diet听as possible 鈥� preferably none.
Saturated fat isn鈥檛 healthy either, but it isn鈥檛 as bad for you听as trans fat. There are two major kinds of saturated fat: Those that听come from animal products (butter, red meat), and听those from tropical sources, like palm and coconut. Most experts think tropical saturated fats are not as听unhealthy as those found in animal products. Nonetheless, I听recommend keeping saturated fat intake low. The American Heart Association recommends less than 16 grams for a person on a 2,000-calorie-a-day diet.
