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.

ANSWER: 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 — 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 “maze” procedure to prevent the abnormal impulses from affecting the entire heart.

It isn’t clear yet who benefits most from these kinds of procedures, but early studies have suggested better outcomes and a good chance for cure, although sometimes it takes several procedures. There are potentially serious complications, so it should only be done only in centers with extensive experience. It is a good choice for people who experience symptoms and can’t take medications or for whom medicines failed.

READERS: The booklet on heart attacks, America’s No. 1 killer, explains what happens, how they are treated and how they are avoided. Readers can order a copy by writing: Dr. Roach — No. 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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.

ANSWER: You are quite right. There are four kinds of fat. Two are healthier — monounsaturated and polyunsaturated, and these are found in healthy oils, like olive oil and canola oil. Two fats are unhealthy — trans-saturated, also called partially hydrogenated, and saturated, which is fully hydrogenated but isn’t 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 “trans,” which are not normally found in nature. The process makes the fat more solid at room temperature. It isn’t 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 as possible — preferably none.

Saturated fat isn’t healthy either, but it isn’t as bad for you as trans fat. There are two major kinds of saturated fat: Those that come from animal products (butter, red meat), and those from tropical sources, like palm and coconut. Most experts think tropical saturated fats are not as unhealthy as those found in animal products. Nonetheless, I 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.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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