"Just how successful is the procedure called catheter ablation at fixing irregular heartbeats that can be potentially fatal Pretty successful a new study found but there are caveats. Burning or freezing specific areas of the heart can alleviate the common irregular heart beat called atrial fibrillation in  percent of patients. However the procedure doesnt work for everyone and there are risks of complications researchers report. Atrial fibrillation increases the risk of early death by two times in women and . times in men. It causes  to  percent of all strokes and can decrease quality of life due to palpitations shortness of breath tiredness weakness and psychological distress the study authors explained. About . million Americans suffer from atrial fibrillation according to the American Heart Association.  For those whose atrial fibrillation cant be controlled with medications catheter ablation may be recommended.  Catheter ablation is a valid alternative for the management of atrial fibrillation with a satisfactory success rate said study lead researcher Dr. Elena Arbelo. But the procedure can have complications which should be considered carefully by doctors and patients said Arbelo a senior specialist in the Cardiovascular Institute at the Hospital Clinic of Barcelona in Spain.  Complications can include fluid buildup around the heart called cardiac tamponade which makes it difficult for the heart to pump blood. Other complications include stroke or ministroke Arbelo said.  In addition many patients need to continue blood thinners and medications that control irregular heartbeats after the procedure she explained.  During the procedure a wire is threaded through the blood vessels into the heart and used to burn or freeze small areas of the upper chamber called the atrium.  The burning or freezing creates a scar and stops abnormal electrical signals that cause the irregular heart rhythm Arbelo said. According to Dr. Hugh Calkins Atrial fibrillation ablation is a wellestablished procedure that has imperfect results. Calkins is a professor of medicine and director of the cardiac arrhythmia service at Johns Hopkins University in Baltimore. The complication rate is higher than hoped and the success rate is lower than hoped he said.  Patients dont get a lifetime certificate saying youre cured Calkins said. For one in four patients atrial fibrillation comes back five years after the procedure. Patients should not be going into this thinking they will have a  percent cure rate with no risk he added.  The new study included information from more than  patients in Europe the Middle East and North Africa. Their average age was  and all had undergone catheter ablation.  Ablation was successful in  percent of patients Arbelo said. These patients had no atrial arrhythmias  irregular heart beats  for three to  months after the procedure. According to Arbelo  percent of patients choose to have ablation to relieve symptoms while  percent do so to improve their quality of life. Atrial arrhythmias in the first three months after ablation were classified as early recurrences and not considered as failures Arbelo said. In addition  percent of patients who had a successful procedure were still taking antiarrhythmia drugs  months later. About  percent suffered complications during the year after the ablation she said.  After the procedure patients with two or more risk factors for stroke should be prescribed oral blood thinners while those with no risk factors dont need them Arbelo suggested.  The study investigators found that  percent of patients with two or more risk factors for stroke were not on blood thinners but onethird of lowrisk patients were taking them.  Dr. Gregg Fonarow is a professor of cardiology at the University of California Los Angeles. He said Relief of symptoms in patients with atrial fibrillation can be challenging.  In certain patients catheter ablation may reduce symptoms improve quality of life and increase exercise capacity though the impact on death and hospitalization risk is still being evaluated he noted.  Of concern is that complication rates are still higher than desirable for this procedure and there was suboptimal use of strokepreventing anticoagulation anticlotting therapy after the procedure added Fonarow who was not involved with the study.  Further trials are needed to evaluate the benefits and risks of catheter ablation and its potential role as firstline therapy he suggested.  Catheter ablation is covered by most insurance including Medicare the researchers said.  The report was published online recently in the European Heart Journal. More information For more about atrial fibrillation visit the American Heart Association http_UCM__Article.jsp. SOURCES Elena Arbelo M.D. Ph.D. senior specialist Cardiovascular Institute Hospital Clinic of Barcelona Spain Hugh Calkins M.D. professor medicine director cardiac arrhythmia service Johns Hopkins University Baltimore Gregg Fonarow M.D. professor cardiology University of California Los Angeles Jan.   European Heart Journal online"