What are the current treatments for atrial fibrillation? There are two main categories: pharmacological treatment and non-pharmacological treatment. Pharmacologic treatments are subdivided into drugs for anticoagulation, also known as stroke prevention, drugs for heart rate control, and drugs to prevent recurrence of atrial fibrillation. Non-pharmacologic treatments, which focus on restoring an irregular heartbeat (atrial fibrillation) to a normal heartbeat, include catheter ablation, hybrid surgery, and therapies to prevent stroke complications of atrial fibrillation, such as left-ear blocking surgery. What is the principle of catheter ablation? As I mentioned earlier, the atria are fibrillating randomly when atrial fibrillation occurs. Why does it fibrillate randomly? Under normal circumstances, there is only one commander in the atria to command the beating of the atria; now there are some lesions and they start to rebel and disobey the commander, thus causing the atria to fibrillate chaotically. Catheter ablation treatment is to eliminate these lesions. The catheter is as thin as the refill of a ballpoint pen, about two to three millimeters. During the treatment, the catheter goes from a vein at the root of the thigh all the way into the heart to find those lesions. Then the tip of the catheter can release some electrical current that produces a very high temperature that burns away those lesions. Finally, the catheter is then withdrawn and the lesions are eliminated, leaving a normal command, and so the atrial beating returns to normal. What is hybridization surgery for atrial fibrillation? Hybrid surgery for atrial fibrillation is when a cardiologist does surgery with a cardiac surgeon to treat atrial fibrillation. Atrial fibrillation lesions that grow inside the wall (inside the atria) can be eliminated by catheter ablation. However, there are other lesions that grow on the outside of the wall (outside of the atria), and if you go to ablate from the inside, you will encounter many problems. First, the wall may be very thick and it is difficult to reach the outside part of the heart with ablation energy. Second, even if the ablation energy can reach, there are some important structures outside the heart, such as the esophagus, and the energy is too high to burn the esophagus, which is a very dangerous complication. Therefore, this situation requires surgeons to operate outside the heart and ablate the outside lesions with some instruments. Cardiology and cardiac surgeons do the surgery together, so it is called hybrid surgery. Can catheter ablation or hybridization cure atrial fibrillation? Yes. Catheter ablation or hybridization are the two main methods used to cure atrial fibrillation. Can you stop a stroke from happening? Yes. When atrial fibrillation is eliminated, strokes do not occur. There are two ways to prevent a stroke: First, although the atria are fibrillating, which causes slow blood flow; however, taking some medication thins the blood so that platelets, etc., do not clump together, and blood clots do not form easily. Secondly, the “bathroom” in the atrium, the heart ear, was closed (left ear blocking surgery), so that blood could not enter. After the left ear is blocked, atrial fibrillation will still occur, but the complications of atrial fibrillation can be minimized. Of course, the best way is to eliminate atrial fibrillation, so that the atria can contract normally without atrial fibrillation, and the chance of stroke will be lowest at this time. What kind of procedure is the left ear blocking procedure mentioned earlier? The procedure is similar to a catheterization procedure, in which a catheter is inserted through the root of the thigh to find the “small mouth and big belly” of the atrium, the atrium, and then a device similar to a corkscrew is released to block the mouth of the atrium. This makes it difficult for blood to enter and form clots; and since the outlet is blocked, even if there are clots, they cannot fall out. With such an interventional procedure, stroke prevention can be achieved in patients with atrial fibrillation. If the catheter ablation or hybridization procedure is successful, will the patient’s symptoms be relieved? The patient’s symptoms will be relieved to a great extent and the risk of stroke will be greatly reduced. Are the risks of catheter ablation and hybridization procedures high? Catheter ablation has been performed in China for many years, and I have been involved in this procedure since 1998 to 1999, when the first few cases were first performed in China, for 15 or 16 years now. The surgery technique is relatively mature. First, this surgery is safe, so it has now become a routine treatment for atrial fibrillation. Second, for patients who meet the indications, the surgical treatment is more effective. （Atrial fibrillation (AF) hybrid ablation surgery is an emerging procedure in recent years, which mainly addresses some complex AF. The risk in terms of surgery has also been dramatically reduced because the surgical part of the hybridization procedure now does not require an open chest, but is done by means of a lumpectomy. A few thumb-thin holes are punched in the left side of the patient’s chest, the camera and operating instruments are inserted, and the surgery is done through a monitor. If viewed from the front, no wound can be seen on the patient’s body, only a few small holes on the side. This surgery is very safe.